Proponents of State Question 802—ObamaCare’s Medicaid expansion provision—have kept much of their messaging quite simple: “More Oklahomans on Medicaid and more federal dollars.” But Medicaid expansion is little more than a house of cards, and one that will threaten to collapse on Oklahoma taxpayers, the truly needy, and the state’s rural hospitals.

While it’s true that Medicaid expansion will bring more Oklahomans into the Medicaid program, voters should question why we need to do so. The Medicaid program was created to insure the truly needy—pregnant women, low-income children, the elderly, and individuals with disabilities. These priority groups are already covered under traditional Medicaid.

In fact, expanding ObamaCare will worsen access for the truly needy, including thousands of Oklahomans with developmental disabilities currently waiting for specialized care.

Expansion opens up the program to a new class of able-bodied, working-age adults who have traditionally not been a target population for government-sponsored welfare. Since states have expanded Medicaid to able-bodied adults, roughly 22,000 truly needy Americans have died while stuck on these waiting lists.

Research shows that expansion states enrolled more than twice as many able-bodied adults in Medicaid than expected and the actual costs per person were nearly twice as high as projections. These massive overruns have drained state budgets hurting other core services.

Take nearby Louisiana, for example. In 2000, long before Medicaid expansion took place in the state, Medicaid accounted for just 22 percent of state spending. Once the state expanded Medicaid, state costs drastically increased, pushing Medicaid’s share of state spending to a whopping 35 percent while education funding dropped 16 percent at the same time.

Proponents of expansion also conveniently omit that 60 percent of Oklahomans who would be eligible for Medicaid expansion already have private health insurance—the most lucrative payer of health care services.

It’s no secret that hospitals lose money on Medicare and Medicaid patients. In fact, Jay Johnson, CEO of Duncan Regional Hospital, has admitted that “on every government payer, we don’t make a profit.”

Rural hospitals, like Duncan Regional, depend upon private insurers to stay afloat, yet Medicaid expansion threatens to move more private payers to Medicaid. This could exacerbate rural hospitals’ financial plight, leaving them to face even greater revenue shortfalls and job losses. That’s why rural hospitals are still closing in expansion states like Arkansas and 15 others.

Reporting from the Foundation for Government Accountability shows that hospitals in Oklahoma already face a Medicaid shortfall of more than $240 million, and Medicaid expansion could raise the shortfall by an additional $106.5 million, the equivalent of more than 2,000 hospital jobs. Do we really want to risk reducing our health care system’s capacity in the wake of a pandemic?

The facts are clear, let us not fall for the expansion bait. Oklahoma must reject Medicaid expansion.