On June 30, Oklahoma will vote on State Question 802, which would amend the state constitution and add a provision to expand Oklahoma’s Medicaid program to include able-bodied adults.

Supporters of State Question 802 promise giving a new right to free government healthcare by expanding Medicaid to able-bodied adults will improve health outcomes, create jobs, and save rural hospitals.

But experiences in other states that expanded show this is just very expensive wishful thinking.

The reality is expansion states have not seen significant improvements in state health outcomes. But their states have been plagued with hospital job loss, state budget shortfalls, and rural hospital closures.

Evidence from the annual America’s Health Ranking report shows expansion states that share similar demographics with Oklahoma, like Arkansas and Kentucky are spending hundreds of millions on Medicaid expansion to get comparable or worse health outcomes than the Sooner State. In fact, expansion state Louisiana with more than 516,000 able-bodied adults enrolled in Medicaid still ranks dead last in overall health outcomes.

Expansion proponents claim Oklahoma will gain jobs, but other expansion states have not been so lucky. According to a recent

According to a recent report from the Foundation for Government Accountability, a national nonpartisan think tank, “two out of five expansion states actually lost hospital jobs after expanding Medicaid, while non-expansion states were growing hospital jobs at a far higher rate.”

Expansion has been no cure all for rural hospitals’ financial woes. According to Becker’s Hospital Review, 24 rural hospitals have closed in expansion states after they expanded. This is largely because hospitals do not make a profit off of any Medicaid or Medicare patient. Any business owner knows that focusing on securing a larger client base of money-losing customers is not sustainable long term.

Proponents also argue the influx of federal cash will offset the state’s portion of expansion costs and states will make hay financially. Then why have 12 expansion states raised state fees or taxes to fund expansion (as pointed out by the Washington Post last year)?

It’s clear our state, like many others cannot afford to expand Medicaid.

Instead of expanding yet another government program, we should pursue targeted solutions to help rural healthcare and improve access.

Reforming our Tobacco Settlement Endowment Trust would be a good start. The $110 million payments made to the state from tobacco companies annually could be directed towards covering losses at rural hospitals. Another portion of this money could be used to pay for medical school students who agree to practice in rural areas upon graduation, ensuring Oklahoma increases the number of providers in areas that need it the most.

There are better solutions for Oklahomans than expanding Medicaid. I urge you to reject State Question 802.

Finley is a policy research fellow at Oklahoma Council of Public Affairs.