With Oklahoma in the midst of what is certain to be a severe and extended fiscal crisis, protecting core public services in every area of state government from deep and painful budget cuts poses a great challenge. However, protecting the budget of Medicaid, the main health insurance program for low-income children, seniors, pregnant women, and persons with disabilities, will present policymakers with special difficulties.

As noted in a recent fact sheet from the Kaiser Commission on Medicaid and the Uninsured, state Medicaid budgets face two distinct dilemmas: “the crunch” and “the cliff”. The crunch refers to the surge in Medicaid enrollment and spending associated with the economic downturn, as those losing jobs and access to employer-based coverage turn to Medicaid for coverage. Nationally, the Kaiser Commission found that total Medicaid spending growth averaged 7.9 percent across all states in FY 2009, the highest rate of growth in six years. As we reported in our last Numbers You Need bulletin, Oklahoma’s SoonerCare (Medicaid) enrollment climbed 8.9 percent between August 2008 and August 2009 and shows no signs of letting up. Read the rest of this entry »