| May 20, 2013

Keep shutting doors on Obamacare's Medicaid expansion in Oklahoma

A few aspects of Obamacare are, per last summer’s U.S. Supreme Court ruling, still voluntary for the states. First among these is Obamacare’s expansion of Medicaid, projected to cost Oklahoma taxpayers a total of $1.6 billion over the next 10 years if implemented.

President Obama’s Department of Health and Human Services (HHS) has used various methods to bribe, threaten, or otherwise persuade states into accepting Medicaid expansion. It now sees the Insure Oklahoma premium-assistance program as a vehicle for getting the camel’s nose under the tent in Oklahoma.

Insure Oklahoma combines state, federal, and private dollars to provide about 30,000 Oklahomans access to affordable health care through both employer-sponsored and individual plans. The individual plans involve Medicaid funds.

Earlier this month, HHS rejected a waiver request to extend Insure Oklahoma past December 31. It seems HHS did so in an attempt to blackmail Oklahoma into accepting Medicaid expansion dollars. In the rejection letter, HHS indicated pathways to preserve Insure Oklahoma, including expanding the program’s Medicaid components to more people.

Obamacare is wrong for Oklahoma, as is Obamacare’s Medicaid expansion. Oklahoma Gov. Mary Fallin has prudently rejected Medicaid expansion in this state.

President Obama’s rejection of Insure Oklahoma is understandably frustrating to employers across the state who utilize it. To be clear, Insure Oklahoma is government-sponsored health care—not a free-market idea. However, if it’s going to exist—and current law mandates that some state tobacco tax dollars must go toward such a program—leaders must watch it closely. Already, the state Capitol is seeing efforts to funnel federal Medicaid expansion dollars through Insure Oklahoma to “save” the program. The door must be slammed shut on this possibility.

Conservative policymakers can use HHS’s rejection of Insure Oklahoma as an opportunity to show that Oklahoma doesn’t always need federal dollars to solve our state’s problems or provide for our citizens. And Oklahoma shouldn’t want dollars intended to finance Obamacare’s implementation. The 2013 legislative session will likely wrap up by week’s end, and lawmakers would be wise to take action before then, to prevent unelected bureaucrats from pursuing Medicaid expansion dollars during the interim.

Policymakers should install several “firewalls” around Insure Oklahoma, preventing it from becoming a vehicle for Medicaid expansion:

  • Cut all federal strings. Make clear that no federal dollars will be involved with Insure Oklahoma, the program will no longer be tied to Medicaid, and the state will not apply to the federal government for additional waivers in connection with the program.
  • Prevent expansion of Insure Oklahoma’s eligibility boundaries. The point of not expanding Medicaid is to not expand taxpayer-funded health care, at the state or federal level.
  • End the Oklahoma Health Care Authority’s practice of robbing funds from Insure Oklahoma to divert to other state Medicaid programs. If the program continues to be used as a slush fund to bolster other insolvent Medicaid programs operated by the HCA, the agency won’t feel the need to reform Oklahoma’s approach to Medicaid, which has become an open-ended entitlement.
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