Will Gov. Mary Fallin refuse federal money to expand the state's Medicaid program under the Affordable Care Act?
Fallin has said through a spokesperson that she is currently weighing the matter, but the decision should be a no-brainer when it comes to human decency. The expansion will make approximately 200,000, low-income Oklahomans eligible for health insurance. That's a significant number in a state with a population of 3.7 million people, and that's why Fallin should brush aside calls in the Republican Party here for her to reject the money.
As we all know, the U.S. Supreme Court recently upheld the ACA, known as Obamacare, but its decision also allowed states to opt out of the Medicaid expansion program contained in the new law. Under the program, states could use Medicaid to cover adults who have incomes up to 133 percent of the poverty level. The federal government would provide the bulk of the money, but states would eventually have to cover some of the expansion costs with matching funds.
Florida Gov. Rick Scott, a Republican, has already said he will refuse the federal money because it would eventually cost his state too much money, and it's been reported the Republican governors in other states are considering rejecting the money as well.
The question, though, is whether the threat of rejecting federal money is more of a political act, an anti-Obamacare gesture, than it is a fiscal decision.
Oklahoma, in particular, with its poor medical care rankings and relatively modest budget, is a place where a Medicaid program expansion could go a long way in improving health care. Obviously, the state could definitely use the extra federal money.
If she accepts the money, Fallin undoubtedly will find herself under fire from conservative extremists in her party, and it could be used against her in a reelection bid. But that's two years away, and the overall view of Obamacare might be much different than it is now. The political risk seems minimal given Fallin's popularity ratings as well.
If Fallin adopts a do-nothing posture and just hopes for repeal, as she did by rejecting federal money to create a health insurance exchange in the state, then Oklahomans could actually end up paying for Medicaid expansion in other states with their federal tax dollars. Meanwhile, our medical rankings here will remain low, and thousands of low-income adults will go without adequate health care.
The new health care law is not perfect, but it's what we have, and it's a start to repairing an unsustainable medical system that has many problems. Fallin should do the right thing by putting politics aside and accepting the new federal money.