Expanding Medicaid threatens Oklahoma’s bright future
By SEN. TOM COBURN & JONATHAN SMALL

Across the country, state policymakers are debating whether or not to implement the Affordable Care Act’s Medicaid expansion. So far, Oklahoma’s leaders have declined to expand Medicaid — a reasoned decision that we applaud.

However, proponents of Medicaid expansion in our state, such as hospitals and some businesses, argue the law includes “money on the table” for states, since under “Obamacare” the federal government says it would pay for 90 percent of the expansion population in perpetuity.

But a future Congress is not bound by current law; it can simply rewrite it. Congress has a history of overpromising funding for states, so it would be folly for states to build their budgets around a promise Congress is unlikely to keep.

Consider a policy analogy from education. In 1975, when Congress passed the Individuals with Disabilities Education Act, Uncle Sam promised to pay 40 percent of each state’s costs. However, over the last two decades the federal government has paid less than half of what it originally promised. For the past decade, the shortfall has cost states nearly $175 billion.

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