Weekly Opinion Editorial
by Steve Fair
Medicaid is a federal and state entitlement program that provides medical benefits to low-income individuals who have no or inadequate health insurance coverage. It guarantees coverage for basic health and long-term care services based upon income and/or resources for eligible Oklahomans. Medicaid is often confused with Medicare, which is health coverage available only to those over the age of 65. Part of the Affordable Care Act(ACA) was the potential expansion of Medicaid by states. If a state expands Medicaid, the federal government matches the state’s share for three years and then the federal match is reduced to 90% with the state required to pick up the difference. Oklahoma is one of only 14 states that has not expanded Medicaid since the passage of the ACA.
Last week, a rally was held at the Oklahoma State Capitol promoting the expansion of Medicaid in Oklahoma. Billed as ‘The Rally for Coverage,’ the group promoted a proposed state question that would expand Medicaid in Oklahoma. On April 19th, a proposed ballot initiative (SQ #802) was filed with the Secretary of State. Once it is approved for signature solicitation, the group will have 90 days to collect 178,000 Oklahoma voter signatures on the petition to get the question on the ballot.
Some state legislators believe that Medicaid expansion is needed. Both State Representatives Marcus McEntire (R-Duncan) and House Minority Leader Emily Virgin, (D-Norman) spoke at Wednesday’s rally advocating for Medicaid expansion. “We(the legislature) have been working, and we’ve been working hard. I’ve put a lot of blood, sweat and tears into the plan that hopefully we’ll be able to unveil,” McEntire said. “I think it’s our job to get this done as the Legislature. We were elected to make these types of decisions, and it’s just silly that the people would have to take it into their hands and go through the ballot initiative process,” Virgin said. Governor Kevin Stitt has stated he doesn’t favor expansion of Medicaid in the Sooner state. Three observations:
First, amending the state constitution by state question mandating Medicaid coverage is a terrible idea. Locking Oklahoma taxpayers into paying for an entitlement program dependent on the federal government portion of funding is foolhardy. While it is the right of any group to distribute an initiative petition and have its day at the ballot box, it doesn’t mean it should pass and become law. Virgin is right that if expansion of Medicaid is to be addressed, it should be the state legislature doing it.
Second, the cost of expansion should be carefully researched. The cost to taxpayers on the expansion of Medicaid in other states has been seriously underestimated. In some cases, more than twice the estimated number expected signed up for coverage. When you consider the federal government mandate for states required to pick up the shortfall as their funding is reduced, expansion is a short term solution to a long term problem.
Third, one in seven Oklahomans (14.2%) are uninsured or underinsured according to the Census Bureau. That is significantly higher than the U.S. average. Because health care providers are required by law to provide service, even to those who are uninsured, financial pressure is placed on those providers. But is it the Oklahoma taxpayer’s job to pick up the bill? Is health care insurance the responsibility of government or individual citizens? Those are questions whose answers appear simple, but when sick people are involved become complex.