Return Medicaid to Its Rightful Role
The program should provide poor Americans with quality care, not shoddy coverage.
By Frank Keating and Doug Beall, July 17, 2017
Rolling back ObamaCare’s Medicaid expansion has become the focal point of the health-care debate, and rightly so. Without fundamental change, Medicaid—expanded or not—will push state budgets to the brink even as it fails to help the most financially vulnerable Americans.
Consider Oklahoma, our home state. Despite intense lobbying by hospital corporations, the state Legislature stood strong and refused the Medicaid expansion. But the Medicaid rolls increased anyway, and at a dramatic cost to priorities like education, public safety and transportation.
Like most states, Oklahoma used to spend most of its funds on education. But a few years ago Medicaid’s rapidly rising costs pushed it to the top of the budget. Today, Oklahoma spends $5.1 billion a year on Medicaid, more than the $3.4 billion a year for K-12 schools and $942 million a year for higher education combined. Medicaid is now crowding out other state priorities, with real consequences in education and beyond: lower teacher pay, fewer textbooks, deferred road maintenance, fewer mental-health treatment options in the state justice system to prevent incarceration of nonviolent offenders, and—within the Medicaid program itself—lower reimbursement rates for doctors.
Something has to give. If policy makers want to preserve a functioning and reliable safety net for low-income citizens with serious health challenges, they must face the fact that Medicaid is failing.