Listen to this article
“We all are going to die.” That was one lawmaker’s response to growing concerns about federal Medicaid cuts — a moment that captured just how casually some in power view life-and-death policy decisions. That particular remark wasn’t from a late-night comedy sketch. It came from a U.S. Representative, spoken directly to constituents expressing real fears.
After the House passed its proposed federal budget — which included deep Medicaid cuts and new work requirements — Speaker Mike Johnson defended the move by insisting there was “a moral component to what we’re doing.” It’s hard to see morality reflected here, given the bill’s projected impact: the nonpartisan Congressional Budget Office estimated that up to 15 million people could lose Medicaid coverage nationwide. However, our Congressional delegation has worked overtime to deny these facts. These cuts won’t go unnoticed in Oklahoma, where SoonerCare (our Medicaid program) covers 1 in 4 Oklahomans.
When people lose health insurance, they don’t stop getting sick — they just wait until it’s worse. This results in more ER visits, higher uncompensated care costs, and a greater burden on hospitals. Our rural hospitals in particular rely on Medicaid (SoonerCare) reimbursements to stay afloat. Nearly two-thirds of Oklahoma’s rural hospitals are already at risk of closing.
The economic cost is just as real. Medicaid generates billions in federal dollars and directly supports approximately 65,000 healthcare jobs in Oklahoma. Every dollar the state spends on Medicaid brings additional federal funding, creating a multiplier effect that helps local economies and keeps providers in business.
And while Congress moves to slash Medicaid, the federal government has also weakened emergency care protections. Previous guidance that reinforced EMTALA — a longstanding federal law requiring hospitals to treat anyone in an emergency, including pregnant patients — has been rescinded. That change may not be part of this bill, but it’s part of the same pattern: making it harder for people to get care when they need it most.
So, when a lawmaker shrugs off the consequences or reframes them as a moral imperative — it’s not just dismissive. It’s dangerous. The consequences are tangible: care denied, hospitals closed, and kids harmed.
Policy reflects values. And the values that our Congressional delegation is displaying here — indifference cloaked in conviction, denial disguised as duty — don’t reflect the needs of Oklahoma. They reflect Washington’s worst instincts. And if we don’t push back, we’ll be the ones paying the price.
Shiloh Kantz is the executive director of the Oklahoma Policy Institute.