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Arkansas, Kentucky and Louisiana expanded their Medicaid programs, yet rank alongside or worse than Oklahoma on the annual America’s Health Ranking report.  According to the Oklahoma Council on Public Affairs, those demographically similar states have spent hundreds of millions on Medicaid expansion to achieve essentially the same or worse health outcomes than Oklahoma.

 

And those states are not outliers. Research has consistently found Medicaid expansion produces no statistically significant effects on self-assessed health. This is because personal behavior and genetics account for 70% of the determinants of health. In the opinion of the OCPA, someone who loses weight and is uninsured will have better health outcomes than someone who is obese with Medicaid coverage.

 

OCPA reports twenty-four rural hospitals have closed in Medicaid-expansion states, including five in Arkansas, Kentucky and Louisiana.

 

Jay Johnson, CEO of Duncan Regional Hospital and a supporter of Medicaid expansion, has explained why. “On every government payer, we don’t make a profit,” Johnson said. “At our hospital, whether we’re taking a Medicare or Medicaid patient, our expenses are greater than what we will get paid.”

 

Medicaid expansion doesn’t increase hospital profits. It increases the number of patients hospitals lose money on, particularly when people are shifted away from private insurance. It’s estimated 70% of those eligible for Medicaid expansion in Oklahoma already have access to private insurance in some form.

 

Supporters say Medicaid expansion is funded by federal money, the federal debt, but it also requires redirecting hundreds of millions in state taxes from needs like schools. In Oklahoma, it’s estimated Medicaid expansion could cost up to $374 million annually. Also, Medicaid-expansion costs have exceeded projections nationwide. The actual cost has averaged 157% more than predicted.

 

Last year Governing Magazine found 13 states had to raise taxes, fees, or cut provider rates to fund the state portion of expansion costs. Indiana initially used a provider tax, but by 2019 the Indiana Hospital Association was calling for other tax increases to fund Medicaid expansion because the hospital tax payments were “increasing at an unsustainable rate.”

 

Jonathan Small. President of OCPA says "Medicaid expansion offers much taxpayer downside, greater control of health care by politicians like Nancy Pelosi, and consumer cost increases due to more cost-shifting, all to achieve little or no benefit. Citizens should vote 'no.'"