On June 30, Oklahoma will vote on State Question 802, which would amend the state constitution and add a provision to expand Oklahoma’s Medicaid program.
Supporters of State Question 802 promise giving a new right to free government healthcare by expanding Medicaid to able-adults will improve health outcomes, save rural healthcare, and create jobs.
But experiences in other expansion states show this is just very expensive wishful thinking.
Expansion states have not seen significant improvements in state health outcomes. Evidence from the annual America’s Health Ranking report shows expansion states that share similar demographics with Oklahoma, like Arkansas and Kentucky, are spending hundreds of millions on Medicaid expansion to get comparable or worse health outcomes than the Sooner State.
Furthermore, expansion states have not been immune to hospital closures, much like Pauls Valley, and state budget shortfalls.
According to Becker’s Hospital Review, 24 rural hospitals have recently closed in expansion states. As Duncan Regional Hospital CEO Jay Johnson stated at a recent legislative hearing, hospitals do not make a profit off of any Medicaid or Medicare patient.
Any business owner knows that focusing on securing a larger client base of money-losing customers is not a good business plan.
Along with closures, came job loss. According to a recent report from the Foundation for Government Accountability, a national nonpartisan think tank, “two out of five expansion states actually lost hospital jobs after expanding Medicaid.”
Supporters also argue the influx of federal cash will offset the state’s portion of expansion costs and states will make hay financially. Then why have 12 expansion states raised state fees or taxes to fund expansion (as pointed out by the Washington Post last year)?
Instead of expanding yet another government program, we should pursue targeted solutions to help rural healthcare and improve access.
Reforming our Tobacco Settlement Endowment Trust would be a good start.
The $110 million payments made to the state from tobacco companies annually could be directed towards covering losses at rural hospitals.
Another portion of this money could be used to pay for medical school students who agree to practice in rural areas upon graduation, ensuring Oklahoma increases the number of providers in areas with the most need, like in Pauls Valley.
There are better solutions for Oklahomans than expanding Medicaid. I urge you to reject State Question 802.
Policy Research Fellow
Oklahoma Council of Public Affairs