Health Care

Trent England | April 29, 2016

Perils of Medicaid expansion explained by state official

Trent England

Politicians may call it “rebalancing,” but the core of the current proposal from the Oklahoma Health Care Authority (OHCA) is an expansion of Medicaid. This is a part of Obamacare rejected by Oklahomans multiple times over the last several years. Unknown to some, a few states actually expanded Medicaid even before Obamacare. Maine is one of those states, and a cautionary tale about the consequences of expanding eligibility for medical welfare.

Since 2011, Mary Mayhew has served as Maine’s Commissioner of Health and Human Services. Before that, she spent 11 years as the vice president of the state’s hospital association. In an interview yesterday on MiddleGround Radio, she explained how, after expanding Medicaid, enrollments and costs far exceeded projections. From 2003 to 2011, the number of Mainers on Medicaid grew from 233,283 to 354,683 when more than a quarter of the state’s population was dependent on the program. Some people dropped private health insurance to sign up for the taxpayer-funded program.

Mayhew described the state of Maine’s social services programs in 2011 as “an absolute financial disaster. After expanding Medicaid, the state was “reeling from one massive financial shortfall to the next and, frankly, believing that that’s how you managed the state’s Medicaid program, that budget shortfalls were a way of life.” And while many states have debated reimbursement rates for healthcare providers, in Maine, at one point after expanding Medicaid, “the state stopped paying hospitals their bills” altogether.

And while “it takes a while to dig out of the crater,” with the leadership of Mayhew and Gov. Paul LePage Maine reformed Medicaid to refocus the program on the most needy. Today, fewer than 280,000 Mainers are on Medicaid and costs are under control. The state’s uninsured rate has dropped below 10%. (Listen to the complete interview here.)

Oklahoma can learn from Maine’s mistakes and more recent successes. The current proposal to expand Medicaid in Oklahoma only “balances” based on guesses made by the OHCA about the number of new enrollees and the costs of care. As Maine learned, such predictions are often far too low. The same thing happened in California, where predictions of 1.5 million new Medicaid recipients turned into 4 million actual new enrollees. Even with federal matching funds and that state’s high tax burden, the Los Angeles Times says the program is “dangerously underfunded.”

OHCA wants to expand Medicaid in hopes of receiving more federal funds. The plan hinges on the Obama administration giving the state permission to shuffle people between Medicaid and the Obamacare insurance exchange. Such a dispensation is far from assured. Even if granted, exchange customers as well as taxpayers who foot the bill for subsidies face “significant premium hikes” in 2017.

Trent England David and Ann Brown Distinguished Fellow

Trent England

David and Ann Brown Distinguished Fellow

Trent England is the David and Ann Brown Distinguished Fellow at the Oklahoma Council of Public Affairs, where he previously served as executive vice president. He is also the founder and executive director of Save Our States, which educates Americans about the importance of the Electoral College. England is a producer of the feature-length documentary “Safeguard: An Electoral College Story.” He has appeared three times on Fox & Friends and is a frequent guest on media programs from coast to coast. He is the author of Why We Must Defend the Electoral College and a contributor to The Heritage Guide to the Constitution and One Nation Under Arrest: How Crazy Laws, Rogue Prosecutors, and Activist Judges Threaten Your Liberty. His writing has also appeared in the Wall Street Journal, USA Today, Washington Times, Hillsdale College's Imprimis speech digest, and other publications. Trent formerly hosted morning drive-time radio in Oklahoma City and has filled for various radio hosts including Ben Shapiro. A former legal policy analyst at The Heritage Foundation, he holds a law degree from The George Mason University School of Law and a bachelor of arts in government from Claremont McKenna College.

Loading Next