Health Care , Law & Principles

Taxpayers shouldn’t subsidize idleness

Jonathan Small | June 16, 2025

Oklahomans don’t mind providing a helping hand to those truly in need. What they hate is paying for others’ idleness. In the view of Oklahomans, those who can work should work.

That’s one of the major problems with the 2020 decision to expand Oklahoma’s Medicaid program to include able-bodied adults with no children, rather than confine the program to children, low-income pregnant women, and the disabled.

That expansion has diverted hundreds of millions of state tax dollars away from other uses in the years since, and the price tag could explode by as much as $700 million per year if federal officials alter the state match for those able-bodied adults to roughly the same level as the state match for disabled people on Medicaid.

It’s one thing to help a disabled individual cover his medical bills, and something else entirely to pay a man in his 20s to play video games.

Fortunately, congressional officials have also proposed allowing states to impose work requirements on able-bodied adults. The proposed work requirement could be met by spending 80 hours a month either working, going to school, participating in a work program, or doing community service.

New research suggests work requirements could significantly reduce Oklahoma’s Medicaid rolls and associated taxpayer expense.

An April report from the Oklahoma Health Care Authority shows that 229,154 able-bodied adults in Oklahoma are currently on Medicaid due to expansion.

Kevin Corinth, a senior fellow at the American Enterprise Institute, reviewed federal data from the American Time Use Survey (ATUS) as well as the Current Population Survey Annual Social and Economic Supplement (CPS ASEC). He found that many able-bodied, childless adults on Medicaid spend most of their time on leisure activities.

“For Medicaid recipients who do not report working, the most common activity after sleeping is watching television and playing video games,” Corinth wrote. “They spend 4.2 hours per day watching television and playing video games, or 125 hours during a 30-day month. That is more than 50 percent higher than the 80 hours they would be required to work or otherwise engage with the community during at least some months under the reconciliation bill. They spend on average 6.1 hours per day, or 184 hours per month, on all socializing, relaxing, and leisure activities (including television and video games). On the average day, they spend about 0.36 hours (i.e., 22 minutes) looking for work, 4.0 hours doing housework and errands, and 0.47 hours (i.e., 28 minutes) caring for others.”

It’s one thing to help a disabled individual cover his medical bills, and something else entirely to pay a man in his 20s to play video games. Medicaid expansion remains a costly mistake for Oklahoma that has produced no meaningful benefit for taxpayers. Fortunately, the reforms being debated in Congress may give the state a way to mitigate the damage.

Jonathan Small President

Jonathan Small

President

Jonathan Small, C.P.A., serves as President and joined the staff in December of 2010. Previously, Jonathan served as a budget analyst for the Oklahoma Office of State Finance, as a fiscal policy analyst and research analyst for the Oklahoma House of Representatives, and as director of government affairs for the Oklahoma Insurance Department. Small’s work includes co-authoring “Economics 101” with Dr. Arthur Laffer and Dr. Wayne Winegarden, and his policy expertise has been referenced by The Oklahoman, the Tulsa World, National Review, the L.A. Times, The Hill, the Wall Street Journal and the Huffington Post. His weekly column “Free Market Friday” is published by the Journal Record and syndicated in 27 markets. A recipient of the American Legislative Exchange Council’s prestigious Private Sector Member of the Year award, Small is nationally recognized for his work to promote free markets, limited government and innovative public policy reforms. Jonathan holds a B.A. in Accounting from the University of Central Oklahoma and is a Certified Public Accountant.

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