Bruce Plante Cartoon: Oklahoma's rich uncle (copy)

Imagine if an investor was offering to bring a $1 billion deal to Oklahoma with strong evidence that it would create thousands of good-paying jobs, set off positive shock waves throughout the state’s economy, reduce crime, improve health and lower debt — all at no net cost to the state.

We’d be foolish to refuse such an offer.

The governor would call a special session of the Legislature to approve all sorts of incentives designed to capture such a deal.

But we’ve been saying no to it for years. The offer is called Medicaid expansion and the billion dollar offer is coming from the federal government.

A 2018 report from the University of Montana Bureau of Business and Economic Research demonstrates the remarkable positive effects Medicaid expansion had on that state after it accepted funding for about 100,000 working-poor adults starting in 2015.

“Medicaid expansion has a substantial effect on Montana’s economy,” the report’s abstract says. “Assuming that enrollment plateaus near current levels, Medicaid expansion will introduce approximately $350 million to $400 million of new spending to Montana’s economy each year.

“This spending ripples through Montana’s economy, generating approximately 5,000 jobs and $270 million in personal income in each year between 2018 and 2020.”

Meanwhile, Medicaid expansion in Montana also reduced crime, improved health and lowered debt, the report found.

The number of poor Montanans in excellent health went up while debt collections and bankruptcies went down. One study cited in the report shows that Medicaid expansion reduced medical debt by $900 per treated person and prevented 50,000 bankruptcies in the state.

And, the report concludes, the cost savings and economic expansion created by Medicaid expansion more than paid for the state’s 10% share of the costs of newly enrolled Medicaid patients.

For example, the report found that the state’s costs for the program were about $33 million in 2017. But the state’s prison health care costs were reduced by $39 million that year because of expansion. Medicaid expansion paid for itself before you even start to calculate the impact of 5,000 new taxpaying jobs in the state.

The same could be true for Oklahoma, only more so. We have more than twice as many eligible working-poor Oklahomans as Montana, so a lot of the economic effects would essentially be doubled.

Oklahoma has turned down Medicaid expansion for political reasons for years, but a lot of other red states — including Montana, Idaho, North Dakota and our neighbors in Arkansas — have accepted the money. Only 14 state have held out. Notable on that list are Oklahoma and Texas, the states with the highest rates of uninsured people in the nation.

Oklahomans are paying for Medicaid expansion here and in the rest of the nation. We’re just not getting any of the services because of our political obstinacy.

Sometime next year, we’ll get a chance to change that. Gov. Kevin Stitt is due to schedule a statewide vote on State Question 802, a proposed constitutional amendment that has already been endorsed by some 300,000 Oklahoma voters who signed the initiative petition calling for Medicaid expansion.

Stitt opposes the petition’s straightforward acceptance of Medicaid expansion, but is likely to offer his own alternative, which might involve a block grant of federal funding. That isn’t a good idea, but it recognize the same business truth that lies behind the SQ 802 proposal: Medicaid expansion is the deal of the century, and Oklahoma can’t afford to turn it down any longer.


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