Oklahoma may be the next state to expand Medicaid, but not everyone sees positives.

According to The Associated Press, a sharp decline in revenue and a billion-dollar budget hole threatens Oklahoma's healthcare system. As a result, some lawmakers – including Republicans – are in favor of shifting thousands of people from Oklahoma's Medicaid rolls onto the federal health exchange created by the Affordable Care Act. Such a move would then make room for adding to Medicaid roughly the same number of working poor who are currently uninsured. Participants would pay nominal premiums and co-pays.

The move, by increasing the number of uninsured people covered, would allow the state to tap into the extra money offered under the federal law. Beginning in 2017, the federal government would cover 95 percent of the state's Medicaid costs, decreasing to 90 percent of the share in 2020.

"It's understandable the temptation to expand Medicaid," responds Hadley Heath Manning, director of health policy at the Independent Women's Forum. "It seems like a quick and easy solution to the problem of un-insurance among low-income people, but unfortunately Medicaid represents two major problems, especially with an expanded population."

Number one on the list, she says: It doesn't come without a cost.

"It is a cost for taxpayers – and most of the expansion is paid for via federal tax dollars," Manning explains. "That doesn't mean Oklahomans aren't paying, [because] of course Oklahomans are also federal taxpayers."

The second problem, she continues, is that the Medicaid program is already thinly stretched.

"And that is to say there are many, many patients who rely on Medicaid coverage; but there aren't as many physicians and healthcare providers who are willing to accept Medicaid coverage because of the lower-reimbursement rates that the program offers for many of the health services that providers can provide."

Manning believes the states ought to be taking a look at how to reform Medicaid and how to empower those patients who are truly indigent poor and cannot afford to buy private health insurance on their own.

"Other than that, to help low-income people, our focus should really be on lowering the cost of private health insurance, so that those people are able to sufficiently purchase their own health insurance and to have better access to better health outcomes."