Recently, Leavitt Partners released a report paid for by the taxpayer-funded Oklahoma Health Care Authority. Unsurprisingly, the report recommends Oklahoma seek “enhanced federal funding” from the Affordable Care Act's Medicaid expansion.
Proponents have gone to great lengths to avoid the words “Medicaid,” “Affordable Care Act,” “Obamacare” or other references that might tip off the public that this is a recommendation to implement Obamacare's Medicaid expansion. This was done due to Obamacare's unpopularity. In May, a Magellan Strategies' survey of likely Oklahoma voters found 70 percent agree with this statement: “Because there is so much disagreement among experts on the costs of expanding Medicaid, we shouldn't rush into any expansion until we have a better handle on the financial consequences.”
Proponents of the expansion argue the report's premium assistance proposal isn't Medicaid expansion. U.S. Health and Human Services Secretary Kathleen Sebelius and her staff disagree. In recent guidance to states on premium assistance, states were told that “beneficiaries remain Medicaid beneficiaries and continue to be entitled to all benefits and cost-sharing protections. States must have mechanisms in place to ‘wraparound' private coverage to the extent that benefits are less and cost sharing requirements are greater than those in Medicaid.”
The report acknowledges that the proposed expansion population has higher risky behavior rates than average and pegs upfront costs at $850 million (this estimate is understated for its use of a healthy population experience for the estimate). Using Obama stimulus-like math, the report tries to wipe this sticker shock away by projecting that economic activity generated by federal funds will actually save the state money. Obamacare is breaking promises left and right, yet taxpayers are to believe funding promises will be kept?