Will state expand Medicaid?
For nearly a decade, one persistent political question in
An initiative petition calling for
That means several Medicaid expansion options could be on the table next year.
But what could
Health impacts
Medicaid expansion would almost certainly lower
But both sides of the expansion debate agree increasing access to health care is not a one-stop-shop solution to cure everything ailing
At 14.2%,
Medicaid expansion would be a big step in the right direction for improving the health of
The purpose of insurance coverage is to reduce the cost barriers that prevent people from getting health care. In states that have expanded coverage, there are fewer adults who report not getting care because of the expense, she said.
"Health insurance coverage is really a necessary condition for improving the health of a state," Collins said.
Other expansion states have seen more people getting cancer screenings, healthier births for mothers and babies, and those states have used the additional federal funding to help address substance use disorder and mental illness, said
The think tank endorsed the proposed State Question 802 to let voters decide whether the state should expand Medicaid.
"We're kidding ourselves if we look to Medicaid expansion to fix every single one of our problems, but it's also a really valuable tool that we absolutely should not ignore," Putnam said.
Medicaid expansion also could allow
Expansion also could improve rural health care, she said. A
Medicaid expansion alone wouldn't have necessarily prevented the hospital closures.
After supporters of Medicaid expansion filed an initiative petition to let
Group co-chairman
"We can expand Medicaid and still have the worst health outcomes in the nation," he said.
Legislators intend to begin the 2020 legislative session with a plan to improve health care in
Medicaid expansion is still part of the conversation because it could help move the needle, but it isn't a complete and total solution, McCortney said.
"The people of southeast
Financial impacts
The 36 other states that have expanded Medicaid provide insights into the financial costs to extend health coverage to hundreds of thousands of additional residents.
If
"However, it is anticipated that the state would be able to offset a considerable portion of its costs," according to the report. Anticipated costs would be closer to
Increased revenue would surface as hospitals spend less on uncompensated care costs and more in taxes. In 2017,
Also, the Leavitt report, commissioned in 2013 by then-Gov.
Savings could come from a few different areas, said Putnam, of the
Other states have benefited from lowered state costs for mental health and substance abuse treatment, as well as cheaper health care for certain inmates in state prisons.
In 2012, the
Under expansion, some services offered by the
The state agencies do not have more recent data on costs savings resulting from Medicaid expansion.
For some states, projected savings would be enough to cover the full 10%. But for others, dedicated general fund dollars, increased tobacco or liquor taxes, new hospital or provider tax rates or higher sales taxes have been used to cover costs, said
Beyond direct impacts to the state budget, the broader economic impacts of expansion have either been positive or neutral, according to a report from the
For many states, more individuals with insurance has meant higher rates of people seeking preventive care, less individual or family debt and healthier, more productive workers, Putnam said.
"The economic ripple effects that we've seen from expansion are pretty incredible," she said.
Generally, states also tend to benefit from the massive infusion of federal dollars into the economy, said Collins from the
"There's a multiplier effect that happens economically in the state," Collins said.
Still, how
And
Small pointed to a failed 2016 ballot measure that would have raised the state sales tax by a penny to pay for teacher pay raises and other education improvements.
"We've just not seen Oklahomans accept programs that will increase their taxes at the ballot," he said.
Expansion critics say the flawed program adds to
They also warn expansion could drastically stress
"It's only a denial of math and reality for someone to say that starting a welfare entitlement for 600,000 people isn't going to put massive strain on the state budget," Small said.
Estimates vary on how many Oklahomans would sign up for Medicaid if coverage was expanded, but most estimates indicate that number would be closer to 200,000 people, not 600,000.
Arguments that the federal government will reduce the 90% match are given too much weight, said
The Trump administration failed to make any changes to the match rate, so it is unlikely to happen, Dorman added. And even in states where enrollment exceeded expectations, that hasn't translated to significant cost increases because "expansion absorbs some of the costs states were already bearing prior to expansion," according to a 2018 report from the
"
"There is very clear evidence of what the impact is on state budgets and those who gain coverage -- it makes people healthier, it creates a healthier workforce and it can be a real net positive for states' economies. The group of states that haven't adopted expansion is shrinking. There is all the evidence they need to make the choice to expand."
There are many unanswered questions and differing projections surrounding the state's health care future. But stakeholders all agree -- something must be done.
"One way or another, I fully expect that we will see something happen," Dorman said. "And truth be told, something desperately needs to happen."
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