Medicaid expansion in Oklahoma isn't happening, but advocates refuse to receive that message. They probably just can’t accept this reality, because the expansion is happening in so many other parts of the country.
It is irresponsible to spend money we don’t have into the federal Medicaid program. The federal government provides a large portion of that money and the state’s portion is smaller, but that doesn’t mean we can afford it. Right now in our state are over 818,000 Oklahomans who depend on Medicaid. The Oklahoma Health Care Authority estimates the state needs $164 million more right now just to cover current needs. To add to that number through accepting more federal dollars and more state responsibility would be foolish from a state budget viewpoint.
The big picture view of what is happening in Oklahoma is that we are a low-income state with limited resources. That history has made us more focused than most on the proper management of what resources we have in building our state budget. We invest heavily in education (over half of our budget) and then try to ensure that we maintain public safety, road and bridge infrastructure, current health programs and a number of other priority services.
Even though education receives a majority of the state budget, our schools are not flushed with money. Despite receiving a large slice of the state budget, they struggle financially. The reason for that is that Oklahoma does not have a huge budget. Schools are receiving a large slice, but that slice is from a small pie.
Right now, we have a prison system that is in dire straits. Corrections officers receive low pay, which has led to a dwindling workforce. Prison populations continue to grow and we do not see an easy fix to this growing problem.
Our road and bridge infrastructure is finally on track, but that will continue to require investment. We also support the current level of Medicaid and a number of other health and social services programs.
I know that there are a lot of Oklahomans who are in need. Unfortunately, I also know that to put too much of our state’s money in Medicaid, would cripple other equally important endeavors.
I also believe that Medicaid, like other federal programs, creates a number of problems in the health care industry. One of the blessings in Oklahoma is having lower health care costs. The silver lining of being unable to fund a Medicaid expansion is that it gives us the opportunity to look at other free market ways to improve the system.
I hope you will keep these things in mind as the Medicaid expansion advocates continue to hammer away at us. The Oklahoma Legislature has made many wise decisions with the limited resources we have. It would be a shame to undo that hard work.