Finances are tight in Oklahoma. In homes from Tulsa to Boise City and everywhere in between people are relearning the importance of being frugal as they continue to wait for the economy to reawaken. This same mentality is true at the State Capitol, where Gov. Kevin Stitt recently took a stand for fiscal responsibility by pulling back from plans to expand Medicaid to able-bodied adults—a plan that would have cost taxpayers billions over the next decade.
The COVID-19 pandemic has brought out a lot of knee-jerk reactions from leaders at every level of government. But while many lawmakers have used the pandemic as an excuse to flout financial responsibility and bust through budgets without thought of the repercussions, it is refreshing to see Gov. Stitt remain steadfast in his support for preserving Medicaid resources for the truly needy by opposing the irresponsible expansion of Medicaid to include a new population of able-bodied adults that the program was not created to support.
Medicaid was designed to provide access to health care for low-income children, pregnant women, individuals with disabilities, and the elderly—people with nowhere else to turn for assistance. But ObamaCare’s Medicaid expansion opens up this safety net program far beyond the program’s mission to include millions of able-bodied, working-age adults—and at great cost to states.
Medicaid expansion states have seen enrollment explode well beyond their projections. On average, these states enrolled 110 percent more adults than anticipated, and per-person costs have exceeded projections by 76 percent. The unsustainable growth is wreaking havoc on many state budgets and is putting resources for the truly needy at great risk. Every dollar spent on Medicaid expansion is one more dollar no longer available for the truly needy.
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Gov. Stitt is right to be concerned about putting Oklahoma on the same path. The Medicaid expansion bill passed by the Oklahoma state legislature, and vetoed by Gov. Stitt, failed to provide a reliable funding stream for Medicaid expansion. Instead, the bill holds future legislatures responsible to make ends meet. And it’s no small amount that’s needed to fund the expanded welfare program. Estimates put the total at $167 million a year—just three million short of the entire Department of Transportation budget.
In his veto statement, Gov. Stitt cited his opposition to the unfunded mandate. To pay for Medicaid expansion, lawmakers would be forced to pass massive tax increases or make draconian cuts to existing state priorities—i.e. funding for education, veterans’ services, law enforcement, transportation, or programs that support the truly needy. And it’s important to note that even without Medicaid expansion, the cost of Medicaid in the state is on the rise. From 2000 to 2018, Medicaid’s share of state spending rose from 15.5 percent to over 24 percent.
Expanding Medicaid is simply unaffordable. And even if lawmakers had access to infinite taxpayer dollars, Oklahomans should ask themselves if adding able-bodied, working-age adults to welfare programs is in line with their own priorities. Gov. Stitt has answered this exact question by putting the financial stability of Oklahoma and care for the most vulnerable before politics. Now it’s Oklahoma voters’ turn.
Medicaid expansion will appear as State Question 802 on Oklahoma ballots on June 30. Voters will be asked to make a big choice about the fiscal health of the Sooner State and whether they’re ok with moving one giant leap closer to the Democrat Party’s dream of Medicaid for all. The choice seems simple to me.
Gregg Pfister is a government affairs director at the Foundation for Government Accountability
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