STATEMENT: Governor’s decision not to join Medicaid expansion is deeply troubling

Oklahoma Policy Institute Director David Blatt released the following statement in response to Governor Fallin’s decision not to join the Medicaid expansion under the Affordable Care Act:

Governor Fallin’s decision not to expand the Medicaid program to cover uninsured low-income adults is deeply troubling and unfortunate, putting politics over the interests of Oklahomans. We are missing a vital opportunity to improve the health of our citizens, bolster the financial situation of our health care providers, and strengthen our state economy.

If we do not expand Medicaid, some 150,000 low-income uninsured Oklahomans will be stuck in a ‘coverage crater’, earning too little to qualify for subsidized coverage through the health insurance exchanges that the Affordable Care Act reserves for individuals earning between 100 and 400 percent of poverty. These Oklahomans will be denied coverage that we know ensures better access to health care services, less financial hardship, and better health outcomes.

Not expanding Medicaid also means that federal taxes paid by Oklahomans will be spent on health care in other states, not here in Oklahoma. Hospitals, community health centers, physicians, and other medical providers across Oklahoma will continue to absorb unnecessarily high levels of uncompensated care, while shifting costs to Oklahomans with insurance through higher charges and insurance premiums.

The Governor’s statement suggests that Medicaid expansion would impose unmanageable costs on the state.  In reality, the expansion is a very favorable deal for Oklahoma. The federal government will pay 100 per cent of the cost for the first three years and ultimately 90 percent of the cost in 2020 and thereafter. The Oklahoma Health Care Authority estimates the state’s share of Medicaid costs in 2020 at $28 – $37 million – an amount that is less than 0.5 percent of current state appropriations. In fact, Medicaid expansion could well save the state money, since Medicaid would pick up expenditures currently paid for with state-only dollars by the Department of Mental Health and Substance Abuse Services and Department of Corrections.

We fervently hope that in the coming months, the Governor will reconsider this decision, and along with legislative leaders, choose to do what is best for Oklahoma’s citizens by expanding Medicaid for low-income adults.

Click here for more information regarding Medicaid expansion and the Affordable Care Act

Click Here to Take Action: Tell Gov. Fallin and legislative leaders that Oklahoma should expand Medicaid for the uninsured.


Former Executive Director David Blatt joined OK Policy in 2008 and served as its Executive Director from 2010 to 2019. He previously served as Director of Public Policy for Community Action Project of Tulsa County and as a budget analyst for the Oklahoma State Senate. He has a Ph.D. in political science from Cornell University and a B.A. from the University of Alberta. David has been selected as Political Scientist of the Year by the Oklahoma Political Science Association, Local Social Justice Champion by the Dan Allen Center for Social Justice, and Public Citizen of the Year by the National Association of Social Workers.

55 thoughts on “STATEMENT: Governor’s decision not to join Medicaid expansion is deeply troubling

  1. PPACA is going to do nothing to improve the health of our citizens and certainly will not strengthen our state’s economy. Medicaid is costing this country millions, if not billions of dollars per year and expanding it will only deepen the debt this country is in.

    There are other, and better, options for low income citizens.

    The idea that state money could be saved by expanding this program is preposterous. Just because that money does not come directly out of state funds does not mean that money is not coming out of our pocket anyway. Just because people think we will save money as a state because the federal government will pick up the tab, is as ridiculous an argument as saying that food stamps are free because the government pays for it. This article states that the federal government will pay 100% of the cost for the first three years and 90% thereafter. Where do you people think federal money comes from? Fantasyland? That money is coming from the taxpayers which, in case you did not notice it, Oklahoma has over 3 million of.

    The statement from the Governor that says Medicaid expansion will cost Oklahoman’s money is a reality. Whether or not that expansion comes from state funds or not. That taxpayer’s still get stuck with the bill in the end.

    1. So what about the fact that 65% of the newly covered would be CHILDREN. Just the same rhetoric with ‘lets not make birth control available’ so these innocent kids live in poverty and go to bed hungry!!

  2. First severe cuts to public education for our children and youth and now forcing cuts to medical care for those most needy…what next? These moves do not foster growth for a healthy Oklahoma economy. My bet is Fallon and the Republican legislature will still talk about tax cuts which will in turn cause further cuts to public services. When will the people of OK wise up and elect those with good sense to govern?

    1. When will the people of OK(or anywhere else, for that matter), wise up and elect those with the good sense to govern, you ask?

      Not until they recognize THE FACT that the Republicans care ONLY about those who have the $$ to keep them in office in perpetuity–and that includes ONLY the wealthy and the rich corporations–by virtue of the now virtually unlimited campaign contributions those entities can provide!

      Why do you think Governor Fallin is so obsessed with giving her wealthy contributors tax cut after tax cut, and she is continuing to pay out all those tax-payer-funded subsidies that are STILL going out to obscenely wealthy oil & gas corporations in OK,like the natural gas production tax credit?
      Seriously–doesn’t ONG make enough $ without that TAX-PAYER FUNDED tax credit (WELFARE)?
      And what about the millions of taxpayer $$ that went to businesses that were actually laying people off, despite the fact that they were supposed to be CREATING NEW JOBS in order to qualify for receiving that money?

      And AT THE SAME TIME,the Republicans were ALSO slashing funding for public education,and for public sector workers, like firemen, police officers,teachers, etc, and they were also actually denying children & the elderly access to critical nutrition programs like SNAP & Meals On Wheels, and access to Headstart and healthcare, while they were handing over billions of dollars to businesses in the form of CORPORATE WELFARE!
      If the Republicans AND THOSE WHO ELECT THEM are so worried about excess government spending,then please explain for us why they keep hasnding over millions in taxpayer-funded subsidies and other “incentives,” and why they don’t seem to haver any problem with THOSE expenditures of the taxpayers dollars?
      The Republicans claim to be representing those in the religious community, and yet, based on their self-serving behavior,and their mean-spirited, hateful attitudes toward the poor and those less fortunate, they don’t know the first thing about the true nature of the tenets of the religious beliefs they profess to represent!
      They use “religion” to provide them with material for their bumper stickers and campaign slogans, just like they use their phoney claims of patriotism, putting country first, etc!

  3. The great thing about Oklahoma is that the majority of the people here have the common sense necessary to realize that entitlement programs such as PPACA is nothing more than legalized government theft. If you don’t understand this, let me give you an analogy. Imagine that we are both grade school students. One day, the principal walks up to you while you are about to buy your lunch and takes half of your lunch money. He then walks over to me and gives me that half because I did not bother to bring my own lunch money. How would you feel now? This is the same thing that the federal government is doing to every taxpayer in this country. Wouldn’t it have made more sense for me to come to you, or somebody else and explain the situation about forgetting my own lunch money and asking if I could borrow some money to buy lunch? Or better yet, having forgot my lunch money in the first place and not being able to eat lunch would probably make me learn my lesson and remember to bring my lunch money the next day.

    Like I said, people with low incomes have other options to receiving health care that are not Medicaid. And I’m not talking about emergency room treatments either.

    1. so what are you talking about Steve? I would like to know where my husband can get proper care for his diabetes and high blood pressure that will give him more than a cursory glance once a month. So please tell me where I can find it? Thank you.

      1. Hey Steve- I would like to know as well. You can go ahead and let us know exactly where we can get affordable healthcare. I have researched and found the lowest rate is the same per month as my truck payment. Where Steve? Where?

      2. Jennifer, I suggest Mary Schrick N.D. in Edmond. Along with conventional doctors she will help your husband. Listen to 890 am Mon.-Fri. 7:00-9:00 am or Sat. 6-9am on 1520am. Good luck but your husband but he will have to change his eating habits and get some exercise. I am not affiliated with her, I just listen to her show.

        1. What is your solution for the families with disabled children, for folks with type I diabetes, hereditary illness etc. As for the lunch money analogy… I can’t even fathom the depth of your compassion.

      3. Now this is not always true, but usually the health problems that are being dealt with are brought on by poor decisions, and lack of personal responsibility. Odds are your husband has type II diabetes brought on by his obesity. And the number one way to lower your blood pressure is weight loss as well. I’m all for helping out those in need, but its hard to help people who wont help themselves. Adding up the authors on numbers, he says we’ll only have to pay 10% of the costs and the government will pay the rest, but how can you be so stupid to not realize that everything that the government has is actually ours to begin with. Based on his math the actual cost of this program will be upwards of 370 million dollars/year. And this is to cover a gap to provide insurance to people making 100-400% of poverty (not actually in poverty by definition). Does this mean this will be for people making $23,000-92,000/yr? Because if health were anything of a priority for you you can afford health care without asking me to pay for it (actually I guess technically this would include me, except I work and have a job, and health insurance comes with it).

        1. Unless you live in a magical world in which everyone knows everything or everyone can learning anything at the snap of their fingers, you need to change your outlook. Poor decisions may be driving some of these issues but leaving people to fend for themselves when they cannot, costs us all more than a little help would. Proper education, a healthy environment, and adequate health care for these individuals as children would have allowed for more productive adults.

          We must break the cycle of poverty and poor education. You doom our children to a world worse than ours otherwise.

      4. Jennifer and Kristy, I choose to ignore Steve and give you a helpful response instead. Please look up Variety Care Community Health Centers. They provide wonderful care with respect and have prevention in mind. They work as a ‘healthcare home’ and you only pay what you can. The staff is amazing and caring and will treat you like you have a million dollars whether you do or you don’t.

    2. All I can say bout Miss Fallin her day is coming cause God doesn’t smile on any one that makes it hard on the poor ppl of this country I say take her medical benefits that i’m sure we are paying for

    3. Steve;
      Since the millionaires across the USA paid millions of dollars to get her elected, she is now trying to pay them back. With this step they will get more of your money when you go to the doctor, and more of your tax dollar at the end of the year. Also with this you will still pay your federal income taxes, and guess what that money will go back to 49 other states and $00.00 back to OK. Keep your head in the sand, keep watching FLAUX feed you their lies over and over until you actually believe it to be true. When Mary decides not to run, the GOP puts an African-American on the ticket, and the Democrats put a female on their ticket, and watch and see who you and all the other rednecks vote for.

    4. Your lunch money analogy is seriously flawed. The child who showed up at school without money for lunch didn’t forget it. He or she more likely had nothing to bring. If I had enough to share so that neither of us would have to go hungry, even if I had to eat a little less, I would happily do that.

    5. You’re analogy is ludicrous at best. You make the assumption that the student (patient) simply forgot his lunch money (forgot to get health insurance). The more appropriate comparison would be to consider that the student (patient) is so poor that lunch money (health insurance), let alone breakfast and dinner is a distant dream only fulfilled by government aid.

      Are you kidding me?

    6. Yes, Steve, why don’t you enumerate all of those other options for Jennifer and the others who may need it?
      You whiners about the government and government spending are continually throwing out all of these vague references to all of these other so-called “services” and “solutions”, but you never actually provide any type of tangible information that might lead someone in need to the help that they may desperately need!
      Why do you make no reference to all of the CORPORATE WELFARE programs–or in your own words–all of the “government theft programs” that exist which hand over all of your hard-earned tax dollars to big businesses that are currently recording record profits and are OBSCENELY PROFITABLE?
      Where is your outrage regarding THOSE WELFARE PROGRAMS that are stealing you blind?

  4. The Affordable Care Act in it’s current form is not good for the economy of any of the states. It will produce a reduction of jobs, higher overall taxes, and less freedom of religion. The bill should return to Washington for revision and a second approval vote.

      1. Apparently not being able to discriminate against your employees based on your personal religion is getting your religious freedom stepped on.

        That is how warped and twisted these people’s minds are.

        They think people should have the freedom to force their own employees to live by their religious rules, if you need a medical procedure that their religion feels is a sin, you are violating their religious freedom by making them pay what a normal person would pay for.

        Never mind you’re having your religious freedom stepped on by having your bosses religious values forced on you.

        This state is a joke. Which is why we have such an inferiority complex which causes us to constantly celebrate anything we can that let’s us show “we’re a state too”.

        We now have a big ol’ skyscraper, shucks. And we have a Bass Pro Shop, and a canal!!!!

        And in our inferiority complex, we pretend we know better than the rest of the world with our good old fashioned pioneer spirit.

        Maybe someday this state will regain a balance and be freed from these right wing fundamentalist hypocritics.

  5. Steve, I don’t really like it either. But we’re already paying the federal taxes for it. So we might as well reap the benefits, right? As the article says, “federal taxes paid by Oklahomans will be spent on health care in other states, not here in Oklahoma.”

    1. Maybe she thinks the open carry law will take care of a lot of the ppl and then she won’t have to worry bout them any more we’ll have another O K corral right here in Okla when some Idiot flys off the handle and kills a bunch of ppl then she can live with it if she has an conciense at all which I doubt not from what I have saw out of her

  6. Steve- still waiting for an answer. Is there a website I can go to? Where is this “better and affordable” insurance that you speak of.

  7. I hope all the Republicans or anyone else that thinks poor people just want handouts, get a clue and realize that just because someone is poor, does not mean they want handouts or are lazy, etc.! I have worked ALL my life since the age of 14! I am 52 now and I’ve had some serious health problems. I have worked for attorneys for years that barely paid a living wage and NEVER provided their staff any insurance while they lived high on the hog! That’s exactly what wealthy people and Republicans do is make money on the backs of POOR PEOPLE then bitch because we need help from the state or government! Is it time to get a new governor yet? Because I can’t wait until we do! But that won’t change the minds or hearts of all the greedy bastards in this state. I just don’t get how this can go on in the free world!

    1. Valarie, you are so right in what you commented. The wages in the State of Oklahoma are really low. My daughter is a teacher and makes less than 34,000 a year and that is before taxes and insurance. She does well to get by but if she had a medical condition that prevented her from working, she would be in the same boat that poorer people are. My sister was a paralegal in Florida and she had looked at jobs here for that position and they paid anywhere from 10.00 to 15.00 an hour where in Florida she was making 25.00 an hour. People that make large incomes will never understand what it is like for the poor or average person. Governor Fallin is a heartless person and so are a lot of other people in this state.

  8. I think we all agree the health system is broken regardless of which side of the aisle we are on. When I see the OKC surgery center offering surgery for carpal tunnel for around $3000.00 and hospitals are more than quadrupled, there is something wrong and that problem arises because there are no free markets operating which causes competition and lower prices. The insane overhead would disappear meaning all the managers that come up with a hospital bill that no one can understand would have to find a new job and drugs wouldn’t be marked up 500% or more. We all have to do our part and ACTIVELY work in a preventive manner through life choices.

    1. Oh no… you don,t work in health care do you? The free market gives providers no incentive. It is more profitable and less disadvantagous for providers to go along with the present system. When was the last time your doctor was able to tell how much meds cost. I am guessing you have decent insurance.

    1. How is it unbiased just because it is from the Cato Institute? The Cato Institute was founded by Charles Koch with a libertarian agenda. Charles Koch doesn’t need to worry about healthcare costs nor the cost of anything that most people do. Charles Koch and his greed are just another part of the problem.

    2. Seriously, though. Anyone who thinks an libertarian think tank will be have unbiased views when it comes to a government program like the ACA is remarkably deluded.

    3. The CATO Institute, Seriously, Tim?
      Perhaps you are unaware that the CATO Institute is one of the Koch Brothers-funded Conservative think tanks, where they hire phoney but legitimate-sounding “experts,” and then pay them extremely well to diseminate legitimate-sounding misinformation to low information voters–like those exclusive Fox “News” viewers–who eat it all up and believe it is the gospel truth!

      The Koch borthers fund a whole network of so-called “think tanks” allover the United States which exist to put out misinformation to a gullible public and they are deigned for one purpose only:TO PROTECT THEIR VAST FINANCIAL AND PROFIT INTERESTS INTERESTS!

      Another of the Koch Brothers greatest hits put out by one of their other “think tanks”: “Global Climate Change is just a big Hoax!”

      Now, one must ask onesself: Why on earth would a couple of old oil, gas & Petrochemical billionaires want to PAY a bunch of bogus climate “experts” to put out a bunch of phoney information that is designed to convince the voting public that global warning was just a joke?

      I suppose one can understand the Republican politicians pushing the ruse–like our very own Jim Idiothoff–because he’s getting his campaign coffers lined very nicely by the Koch boys, I’m sure!
      Ask yourself this: What other possible motive could the Koch brothers have, I wonder?

      If you like websites, check out the website “The Koch brothers Exposed: if you want an education–and then check out their other organization ALEC (The American Legislative Exchange Council) & you’ll definatrely want to check out thae ALEC EXPOSED website!

  9. The statement that medicaid expansion would “bolster the financial situation of our health care providers” is a complete joke. Coming from a health care provider – it would do the opposite.

  10. I don’t understand how you can think this benefits us. If you think that by the poor not having insurance helps the state, you are so wrong. First of all, they don’t have preventative health care and second, everytime a poor person gets sick, they end up going to the emergency room where it will cost hundreds if not thousands, when it would have been so much cheaper for an office visit. Also, if a poor person has a condition such as cancer, the state will pay for the treatment so by turning down this plan, it does nothing to help Oklahoma save money. Also, you take someone that isn’t poor enough to qualify for health benefits through DHS but has a long term illness, they will loose whatever they have and will have to file for bankruptcy. My husband was diagnosed at age 48 with stage IV Non-Hodgkins Lymphoma. He worked at the Post Office and was retired from the Navy so we had an middle income life but then we lost everything we owned because he could no longer work. We did have insurance so all his treatment was covered and it cost at least a couple of hundred thousand or more for his care before he died. I also was fortunate because we did carry life insurance but for the people that don’t have either, they will be devastated.


    The above website is just one of the options that Mr. Long was talking about. There are plenty of free clinics around town. Try a local church. They my help you supplement your income with food or even money. Ask a family or neighbor for help. Have a healthy family member work multiple jobs. Live in a colder house during the winter and a warmer house during the summer. Take quick showers. Trade your cable bill in for a library card. Tighten that belt I know I am. Government will never solve or problems.

      1. Did you read my whole comment? Yes there is a place where the poor in Oklahoma can get health insurance. This snap your fingers and make magic happen mentality is not going to work. What about my other ideas?are they too straight forward and honest for you?

        1. You’re making the assumption that individuals taking advantage of this affordable insurance are living lavishly and have money to spare if only they’d tighten up the belt. While this may the case for some individuals, I highly doubt this is true for most individuals on these plans.

    1. Stephen, please realize that many of those in need of these services already have no cable, Internet access, or vehicles of their own. They often have little education and few resources from which to draw. Poor neighborhoods may have people and churches but there’s no reason to believe either of those will have resources to help with. Talent, intelligence, and perseverance are not substitutes for an adequate environment in which to thrive.

      Government can and must provide a reasonably safe and mutually advantageous environment for us all to live. How would you fare without the FBI, FDA, USDA, EPA, etc. to keep you safe from criminals, unsafe drugs, dangerous foods, tainted water, and other such dangers?

  12. This willful failure to act in the best interest of the State’s citizens may be grounds for impeachment of the governor. She is committing a willful and negligent act of omission which endangers the health and lives of a significant number of citizens, including children. It’s certainly worth exploring!

  13. I want to point out, that yes, there are clinics around Oklahoma that have great sliding fee scales. We can go to those clinics and I will happily do so as the one in my area has good docs and a good support system. What will not happen in this clinic is that any medication prescriptions written will be totally out of my pocket and at my age these will end up not being cheap. I also do not qualify for any of the low cost medication programs. Why is not of public concern and I will not argue about it. I can go to Planned Parenthood for my annual check ups, but they will not cover the cost of blood panels and medications. I’m one of the lucky ones that I can even begin to afford to go in to a low cost clinic. Many as they struggle to establish themselves in the workforce or have a full sized family they have to support can not afford what they will see as a luxury.

    I truly want to know if those commenting on this site that are so against the AHCA have had to do without medical care or have a loved one that has to have constant health maintenance, such as Diabetes or Asthma. By the by folks, Type 1 Diabetes is NOT controlled with diet, is NOT brought on by bad diet or bad choices. In fact most diseases that require permanent medication are not a result of bad choice, but of genetics and circumstance. Many times, for those that think diet is a choice, those that live under the poverty line, can not afford to eat healthier foods, as the cheaper foods are not on a healthy choice list. Countries that have high disease rates tend to be those with a large population that lives in poverty. Take care of our people and the people will be healthy enough to work and most of us want that.

  14. This is just another sign that republicans are not in touch with what people are going through and they don’t care. It sounds to me like we need to vote in a more resposible governor who really cares about the people and not just the rich.

  15. I wonder if Mary Fallon cares that she will be responsible for some uninsured folks deaths that will result in her decision to deny healthcare that is offered free for the first three years? Some folks will no doubt die because of her actions. Does she believe herself to be god, deciding that these folks are not worthy of life? They are just undeserving lazy wretches to her. Republican Christian values:)

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