A senate review by Senator Al McAffrey

Oklahoma State Senator Al McAffrey. Photo provided.

(Oklahoma City – Feb. 7)  There has been some misinformation floating around about the National Affordable Care Act (ACA) and the 2014 Medicaid expansion.  As you know Governor Fallin opted Oklahoma out of receiving the federal funding that our state was entitled to in order to cover the costs associated with this plan.  I think that was a horrible mistake. 

By opting out of the system, Oklahoma is essentially turning away an average of $333.2 million in additional annual federal funds, which would offset any costs to the state of expanding the Medicaid system. That number is based on the estimate that only 57% of eligible Oklahomans would even apply for the new program. 

States like California are already asking if they can have Oklahoma’s share of the funding to use in their state.  Do we want our tax dollars going to California? 

Our state desperately needs these funds.  Nearly one in six Oklahomans (636,000) is currently uninsured.  SoonerCare (Medicaid) has a current total enrollment of 765,065, or about 20 percent of the total population.  Of this number, 65 percent are low income children and 35 percent are low income parents, and disabled or aged adults.

Oklahoma ranks 46th in the nation in health status according to the 2011 State of the State’s Health Report.  Each year, Oklahoma experiences 5,200 more death than the national average.  Studies have proven that there is a direct correlation between health status and access to health insurance. 

So what does Medicaid expansion mean to Oklahoma?  The ACA expands Medicaid eligibility to nearly all individuals under the age of 65 with incomes at or below 133% of the Federal Poverty Level (FPL).  For a family of two, this equates to an annual income of $20,123.  Expanding eligibility in Oklahoma would allow 200,000 more Oklahomans access to Medicaid, assuming all enroll, potentially reducing the number of uninsured Oklahomans by at least 31%. 

The Governor opted out of the federal program saying it would be unaffordable and cost the state up to $475 million between now and 2020.  That $475 million amount assumes 100% of eligible would enroll in all years between 2014 and 2020, in addition to all of the 44,000 children and 17,000 low income parents in Oklahoma who are currently eligible but not enrolled in Medicaid, and also includes all applicable administrative costs. 

In reality, according to the Oklahoma Hospital Association, even using the Governor’s assumption of a $475 million cost to the state for the same period of time, Oklahoma would still receive $3.89 billion in federal matching funds.  That means Oklahoma would get a return on it’s investment of 8:1.  We also must remember the annual savings in other state expenditures the expansion would cover, such as the Department of Mental Health and Substance Abuse Services, Department of Corrections, and Department of Health (estimated to be $47.6 million annually).

Next week, I’m going to discuss another reason I think it’s bad that Oklahoma turned down these federal funds and that’s the tremendous financial burden it’ll put on our state’s hospitals and the devastating affect this decision may have on our rural hospitals. 

If you have any questions or comments, I can be reached by email at mcaffrey@oksenate.gov or by phone at (405) 521-5610.  You can also write me:  Senator Al McAffrey, State Capitol, 2300 N. Lincoln Blvd. Room 527A, Oklahoma City, OK, 73105.