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OCPA Critiques Medicaid Expansion Plan

May 3, 2016 - 12:38pm CDT

The Oklahoma Council of Public Affairs and the Foundation for Government Accountability have recently released a study titled “Out of Balance.” The study analyzes the latest proposal to expand Medicaid in Oklahoma.

A new proposal by the Oklahoma Health Care Authority proposes kicking 175,000 pregnant women and children off Medicaid and into the health care exchange to make room for hundreds of thousands of able-bodied adults. While thousands of Oklahomans with real needs continue to sit on waiting lists for services, OHCA’s own consultants estimate that as many as 628,000 able-bodied adults would be newly eligible for Medicaid under the OHCA’s latest plan. 

“The most vulnerable—the population Medicaid was originally designed to serve—deserve access to quality health care,” said Jonathan Small, OCPA president. “Oklahoma shouldn’t ask the most vulnerable to continue to wait for care and lawmakers to accept an unaffordable Medicaid expansion for able-bodied adults whenever options for responsible Medicaid reforms exist.”

The study also takes an in-depth look at the fiscal impacts of expansion in other states.

“In states with available data, Medicaid expansion enrollment surpassed initial projections by an average of 91 percent in 2014,” said Jonathan Ingram, vice president of research at the Foundation for Government Accountability. “States have now signed up more able-bodied adults for Medicaid than they thought would ever enroll – and in many states, more than they thought would even be eligible – leading to billions of dollars in budget overruns."

Ohio’s Medicaid expansion is currently $3.1 billion over budget and is expected to run $8 billion over budget by the end of 2017. In Illinois, Medicaid expansion has run roughly $1 billion over budget each year. Additionally, Nebraska state actuaries estimated that using commercial plans, as proposed by the OHCA, to expand Medicaid would be nearly twice as expensive as traditional Medicaid expansion.

“OHCA’s proposal guts Insure Oklahoma by removing enrollment camps, work requirements, and accountable cost sharing,” said Small. “Instead of accepting this proposal, lawmakers need to refocus efforts on improving Medicaid for the most vulnerable.”

The two organizations offer six reform ideas, which are outlined in the study.

The full study can be found at ocpathink.org/medicaid.