Small: Medicaid expansion’s harms continue

Medicaid expansion’s harms continue

By Jonathan Small

A key plank of Obamacare (the federal “Affordable Care Act”) allowed states to expand Medicaid programs to include able-bodied adults and not just the medically needy.

 

When expansion was narrowly approved by a public vote in Oklahoma in 2020, everyone knew it would require the diversion of up to $300 million annually in state tax dollars. But advocates called that a bargain since federal tax dollars would cover 90 percent of costs.

Obviously, it meant little to the average citizen if they pay for expansion with taxes paid to the state or taxes paid to the federal government, but that’s the kind of argument that too often passes for logic in politics.

But now the folly of buying that argument is becoming even more apparent.

Critics have long warned the 90-10 split was likely to change. Now that federal officials are trying to bring spending under control, there’s a good chance the 90-10 split could be replaced by something closer to a 60-40 split. If that happens, the state cost of Medicaid expansion could surge by $500 million to $700 million per year.

Facing that scenario, state officials should place repeal of Medicaid expansion before voters. And in the meantime, they should enact any associated budget cuts solely within Medicaid. If Medicaid expansion caused the state shortfall, Medicaid should take the hit.

Medicaid expansion was supposed to save rural hospitals. It hasn’t.

A 2024 study from the Foundation for Government Accountability found hospitals losses from Medicaid increased 115 percent from 2013 to 2021 in states that expanded Medicaid, but just 6 percent in states that did not.

In 2024 the Chartis Center for Rural Health found 22 rural Oklahoma hospitals were vulnerable to closure. A larger percentage of Oklahoma rural hospitals were vulnerable to closure than their counterparts in several states that did not expand Medicaid (such as Texas, Wyoming, Wisconsin, Mississippi and Georgia).

Similarly, a 2023 report by the Center for Healthcare Quality and Payment Reform found that about half of Oklahoma’s rural hospitals were at risk of closing with nearly one-in-three at risk of “immediate” closure.

Those numbers are significantly worse than prior to Medicaid expansion.

Similarly, Medicaid expansion has produced no notable improvement in health outcomes.

In 2019, the America’s Health Ranking report ranked Oklahoma 47th out of the 50 states in health outcomes. Today, Oklahoma is … still ranked 47th. Outcomes in several non-expansion states are significantly better.

Put simply, Medicaid expansion could quickly break the state budget, has done nothing to benefit hospitals and has failed to improve health outcomes.

As Oklahomans face a potential budget shortfall caused by Medicaid expansion, they should assess if expansion has provided meaningful benefits. Any serious analysis will end with a simple one-word response: No.

Jonathan Small serves as president of the Oklahoma Council of Public Affairs.

Walters touts Teacher Freedom Alliance, alternative to "Woke Teachers' Unions"

Walters Touts Alternative to Woke Teachers' Unions

Teacher Freedom Alliance provides a necessary free market solution

OKLAHOMA CITY, OK (March 10th) – Today, Superintendent Ryan Walters announced intent to lead the charge to offer a private industry solution to the far left-leaning Teachers' Unions that have infected our public education system for decades. The Freedom Foundation launched the Teacher Freedom Alliance (TFA) on Saturday, introducing a program that provides liability coverage for teachers, promotes historically accurate curriculum, and offers professional development opportunities. These measures aim to help excellent teachers be rewarded for their proficiency rather than their longevity and allegiance to the union.

Efforts underway to save USS Batfish with proposed Oklahoma War Memorial & Museum

Count me in. The USS Batfish is a hero of WWII, and an Oklahoma treasure, and deserves saving. A big thanks to Lieutenant Governor Matt Pinnell for his years of support for securing the Batfish for generations to come.

EFFORTS UNDERWAY TO SAVE THE USS BATFISH WITH PROPOSED OKLAHOMA WAR MEMORIAL & MUSEUM

Muskogee, OK (March 10, 2025) - The USS Batfish, a legendary World War II submarine and beloved Oklahoma landmark is at risk of being lost forever if not relocated to a new site. After devastating floodwaters in 2019 displaced the vessel from its foundation, the submarine suffered damage and was forced to permanently close to the public. With critical flood mitigation efforts underway and necessary controlled access measures required at the entrance to the current site, relocating the Batfish to a permanent home at Port Muskogee’s Three Forks Harbor is essential to its preservation.

Hello, Walters? Controversial Waurika school assignment was from State-approved curriculum

This is a follow-up to my article from Wednesday, Perverted assignment given to students at Waurika High School, which covered a very detailed high school class assignment on sexual activities, including illegal and unnatural acts.

Parents in the community were rightfully upset, as pictures of the assignment quickly disseminated among even elementary students at the school. 

Jenni White at Reclaim Oklahoma Parent Empowerment (ROPE) interviewed the mother who first went public with the perverted assignment (you should read the whole thing):

A truly unfortunate event happened in the classroom of Ashlyn Jade’s niece at Waurika Public Schools Monday afternoon.

According to an interview with Ashlyn this afternoon, Coach Roger Jesse, a teacher/coach with 40+ years in Oklahoma education – and someone with many years of service and an excellent reputation in Waurika Public Schools – gave his 11th grade psychology class an assignment that has now made internet viral status.

Coach Jesse was asked to teach a new extra curricular psychology class at Waurika High School this semester. Ashlyn believes that, in a hurry and under duress from a strenuous teaching/coaching schedule, he downloaded a STATE APPROVED psychology curriculum to use during his class on Monday afternoon, copied it and handed it out without really reviewing it.

OK Senate Appropriations Committee passes tax reform measures

An income tax credit during years of growth, rather than a full blown tax cut? I'm a bit skeptical of the idea (it's certainly a novel proposal that I've never heard of before).

Senate Appropriations Committee Advances Tax Reform Measures to Strengthen Oklahoma’s Economy

OKLAHOMA CITY (March 6th) – The Senate Appropriations Committee passed a series of tax reform measures aimed at simplifying Oklahoma’s tax code, providing relief to individuals and businesses and promoting economic growth. 

Senate Bills 304, 299, 291, and 60, authored by Senator Dave Rader, R- Tulsa, and Adam Pugh, R-Edmond, address income tax structure, corporate tax fairness and taxpayer relief mechanisms.

Perverted assignment given to students at Waurika High School

UPDATE: Hello, Walters? Controversial Waurika school assignment
was from State-approved curriculum

Heads up, content warning. This sexually perverted assignment was given to students Monday in a psychology class at Waurika High School with no apparent prior notice to parents.

It was part of the class curriculum, and school officials are claiming they had no idea it was in there (why they don't know what's in what they teach is a good question). I'd also ask what else is in this curriculum. 

Waurika, Oklahoma. Population 1,837. High school with approximately 125 students. 

Certifiably insane, morally destructive, culturally suicidal stuff like this is being taught to children in rural and small town public schools in even red-state Bible-belt Oklahoma.

If you value virtue, biblical morality, a decent societal future, and common sense, speak up.

I might also recommend homeschooling your kids. If you have questions about how to homeschool, send me an email (JamisonFaught@MuskogeePolitico.com) and I can either communicate with you directly or connect you with helpful resources.

Two statewide officials trade taxpayer-funded letters to push their own campaign interests

In which one announced gubernatorial candidate uses his official state government position and office to chides another probable gubernatorial candidate and would-be opponent for using his official state government position and office to advance himself and create political drama, all while criticizing the current governor with his campaign talking points on taxpayer letterhead.

They would both do well to be careful about using our tax dollars to unethically and illegally put the thumb of government on the scale for their political campaign.

Attorney General Gentner Drummond and State Superintendent Ryan Walters

‘Manufactured political drama’: Drummond responds to Walters’ request for formal opinion on Presidential executive order

OKLAHOMA CITY (March 3, 2025) – In a letter sent today to state Superintendent of Public Instruction Ryan Walters, Attorney General Gentner Drummond labeled Walters’ request for a formal Attorney General’s opinion on a Presidential executive order as “nothing more than manufactured political drama,” as the order is clearly the purview of the U.S. executive branch.

Drummond praised President Trump for his "dutiful and comprehensive” efforts to curb illegal immigration into the United States, and criticized Governor Kevin Stitt for his "many failures in dealing with this critical issue here in Oklahoma."

Walters requested the opinion Feb. 24 after President Trump issued an executive order directing federal agencies to prevent taxpayer resources from acting as a magnet for illegal immigration and to end taxpayer subsidization of open border services to illegal immigrants.

Drummond explained that the executive order does not involve state agencies and advised Walters to "cooperate with ... federal agencies to faithfully implement the Executive Order."

“As a reminder, the framers of the U.S. Constitution enshrined within it the concept of federalism," Drummond wrote. "This means that the United States and the several States are distinct and separate sovereigns. As a result, President Trump is the head of the Executive Branch for the United States Government. The President issues executive orders that direct the actions of federal departments, agencies, officers, employees, and contractors; while a Governor issues executive orders that direct the actions of state departments, agencies, officers, employees, and contractors.”

Drummond hailed the Executive Order, "Ending Taxpayer Subsidization of Open Borders," as a model for every state while criticizing Gov. Stitt for six years of failure to take substantive action to curb taxpayer-funded services to illegal immigrants in Oklahoma.

“In fact, President Trump’s leadership addressing illegal immigration has been so strong and decisive that it has laid bare Governor Stitt’s many failures in dealing with this critical issue here in Oklahoma,” Drummond wrote. “For more than six years in office Gov. Stitt took no substantive action to address illegal immigration here in Oklahoma. Quite the opposite, Governor Stitt partnered with the Biden Administration to ‘resettle’ over 1,800 poorly vetted Afghan ‘refugees’ in Oklahoma. You recall that the FBI recently arrested one of them for planning a mass shooting on Election Day in 2024. Worse still, an audit revealed that Governor Stitt improperly spent over $6.5 million in taxpayer funds to ‘resettle’ these ‘refugees’ without appropriate authorization.

“I am very thankful for President Trump’s leadership on this critical issue, and I am very disappointed in Governor Stitt’s failures that have cost Oklahoma taxpayers billions and put our families at risk. [The executive order] should be a model for Oklahoma and every state to ensure their services are delivered only to those legally eligible to receive them.”

In closing, Drummond advised Walters to stay focused on his own responsibilities as Superintendent of Public Instruction.

"I suggest you devote increased energy and focus on improving the test scores and reading proficiency of Oklahoma Students," Drummond wrote. "The people of this state entrusted you with the critical responsibility of administering and managing public education. Fulfilling that responsibility should be your only focus."

Read the full letter.

Thompson's food safety bill advances to OK Senate floor

Senator Kristen Thompson’s Food Safety Bill Advances in Senate

SB 4 Prohibits Harmful Food Additives Linked to Health Risks

OKLAHOMA CITY(March 3rd) – The Oklahoma Senate Committee on Agriculture and Wildlife has passed Senate Bill 4, legislation by Senator Kristen Thompson, R-Edmond, aimed at protecting public health by banning certain harmful food additives.

Senate Bill 4 prohibits the manufacturing, sale and distribution of 21 substances commonly found in processed foods that have been linked to health risks, including hyperactivity in children, hormonal disruption, and potential carcinogenic effects.

Small: Seven ways to boost reading outcomes

Seven ways to boost reading outcomes

By Jonathan Small

I’ve written about Oklahoma’s appalling reading outcomes, which have fallen dramatically and are now among the worst in the nation.

Fortunately, lawmakers have banned the use of “three cuing” instruction that mostly involves teaching a child to guess rather than sound out words.

But more can be done. Here are seven policy steps to improve reading proficiency in Oklahoma.