U.S. Sen. Tom Coburn is publicly urging Gov. Mary Fallin to reject federal money to expand the state's Medicaid program under the Affordable Care Act.
"I do not think expanding the Medicaid program in Oklahoma is in the best interest of the taxpayers and patients in Oklahoma," Coburn wrote to Fallin on Monday. "Focusing on managing the current program -- rather than expanding it -- is more responsible and compassionate than increasing spending and ceding more control to the federal government."
Federally funded expansion of the state Medicaid program is the law's primary means of expanding health-care coverage to low-income families. Households earning as much as 133 percent of the federal poverty rate -- now $30,657 for a family of four -- would be Medicaid eligible.
But this summer's Supreme Court ruling that upheld the law's constitutionality made optional state participation in the Medicaid expansion. Several governors, including Rick Perry of Texas, have already rejected the expansion.
Fallin has put off a decision on whether Oklahoma will accept the funding until after November's presidential election.
"Gov. Fallin appreciates and values Sen. Coburn's input," said Alex Weintz, a spokesman for Fallin. "As she has said in the past, the governor does not plan to announce any decision regarding Medicaid expansion until after the election. She does, however, share Sen. Coburn's concern that any expansion could result in additional costs to taxpayers and to the state of Oklahoma."
In his letter, Coburn argues that Oklahoma taxpayers will have to bear higher costs because of the expansion.
The law promises that the federal government will pick up 100 percent of the newly eligible enrollees for the first three years, then gradually shift some of the costs to the states, capping at 10 percent in 2020, but Coburn points out that that's a distinction without a difference to taxpayers.
"There is only one set of taxpayers, and some portion of federal contribution would still be borne by Oklahomans -- whether through their federal or state taxes," he wrote.
Coburn warns Fallin not to rely on the federal government to come through with its promised funding.
"While the federal government may initially fulfill their promised matching rate, what will happen when politicians face reality and decide the federal government can no longer afford to pay the rate as promised?" he asks.
There is already talk in Washington that could lead to more of the costs being shifted to states, Coburn says.
Expanding Medicaid would effectively reduce private health insurance options in Oklahoma and perpetuate federal bureaucrats' control over Oklahoma's Medicaid program, Coburn writes.
"We need Oklahoma to design a program that best fits our state's needs, rather than be subject to the whims and dictates of federal bureaucrats," his letter says.
Coburn also makes two more hypothetical arguments to Fallin: Low Medicaid reimbursement rates to health-care providers could limit medical access to patients in the future, and essential medical care may not be available to all patients on the program.
Although neither situation may describe Oklahoma's situation at present, the experience of Medicaid patients in other states should be taken into account when considering what to do about expanding the program, he writes.
Distributed by MCT Information Services
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