October 10, 2014

Medicaid Expansion: Wisconsin Got It Right

On paper, Medicaid coverage appears far better than what most Americans enjoy—with lower cost-sharing and unlimited benefits. But by almost all measures, Medicaid enrollees fare worse than similar patients with private insurance and often experience worse health issues than patients with no insurance. Wisconsin made a wise choice when it decided to forgo a full Medicaid expansion in favor of a smaller program that would maximize the availability of private coverage for Wisconsin’s low-income residents.

Medicaid Expansion - Wisconsin Got It Ri[...]
Adobe Acrobat document [1.6 MB]

September 19, 2014


The State of Oklahoma recently chose not to expand Medicaid under the Affordable Care Act provisions. The expansion would have swelled coverage to adults with incomes up to 133% of the federal poverty level, creating a substantial increase in the number of people covered by Medicaid. With the state already struggling to fund the one in four Oklahomans on Medicaid, the proposed expansion would have caused significant budget concerns by pushing enrollment to one in three Oklahomans on Medicaid (33% as compared to the current 27%). Jagadeesh Gokhale, a member of the Social Security Advisory Board, estimated that by 2023, the Oklahoma Medicaid bill could be as high as $6.5 billion per year, the same as the entire state appropriated budget in 2012.

Medicaid Expansion Bad For States.pdf
Adobe Acrobat document [26.9 KB]

February 19, 2014

Oklahoma has moved most of its Medicaid enrollees into privately-administered managed care plans under a program known as SoonerCare. The state should also move Medicaid enrollees to managed drug plans. Virtually all state Medicaid programs distribute some drugs on a fee-for-service (FFS) basis separately from any health plan, but Oklahoma is one of the minority of states that distribute almost all their Medicaid drugs this way. State Medicaid programs that carve out drug benefits often ignore drug therapy coordination and management. By contrast, integrating prescription drugs benefits with Medicaid managed care health plans improves quality and increases efficiency. In addition, privately managed Medicaid drug plans are more efficient than state-administered Medicaid drug benefit programs. Legislators will likely find that drug plan managers will lower costs if they allow drug plans to compete.

Reforming Oklahoma's Medicaid Drug Progr[...]
Adobe Acrobat document [423.1 KB]

November 25, 2013


In the debate over expected growth in Oklahoma’s Medicaid costs as a result of President Obama’s health care law, it’s important to get the numbers right. If Oklahoma’s Medicaid population were to grow as a result of the law, Oklahoma taxpayers would be left to pay the bill. It’s nice to know how much something will cost before you buy it. In the end, it would appear that Oklahoma made the right economic decision to reject the Fed’s demands.

Costs Of Medicaid Expansion In Oklahoma
If Oklahoma had agreed to a Medicaid expansion, normal governmental functions would have likely suffered.
Oklahoma Medicaid Expansion.pdf
Adobe Acrobat document [281.5 KB]

Get in Touch With Me.

Call me at 405 810-8119 with any questions or to schedule an appointment.


Greg Karnes CPA

4301 NW 63rd St, Suite 200

Oklahoma City, OK 73116-1504


Or you may use my contact form.


Competitive Fee Structure


… but if you are looking for the cheapest fees, or obesssing about your correct pronouns or global warming, you are probably best served by looking elsewhere…

… in addition, due to an extremely busy workload, if it is absolutely critical to have a rapid turnaround in your work & you are inclined to make repeated calls to check on the status, someone else would probably suit you better …

New tax clients are expected to provide copies of their last 3 years of tax returns and provide permission to contact prior accountant to resolve any issues, if necessary.


Regretfully, I am unable to accept new clients who have unfiled prior-year’s tax returns, who are not current with all prior tax obligations, are involved in any marijuana-related business ventures, use marijuana, have any income from gambling, are experiencing extreme financial difficulties, are personal-injury attorneys or copyright or patent trolls. Newly formed businesses are frowned upon as well.


Though not required, supporters of President Donald J. Trump, the National Rifle Association & clients who are cheerful, optimistic and NOT easily offended are generally preferred.




Due to the alleged gang activity and drug dealing at the nearby Chelsea Manor Apts. & 7-11 Convenience Store, I would personally recommend "packing some heat" while in this area (and perhaps Penn Square Mall as well). Some believe the OKC Police Dept. has become wussified and are too intimidated to confront these gangbangers and put them behind bars where they rightfully belong. "Talk on the Street" seems to be that the wussification emanates from an extremely weak & naive Mayor who purportedly suffers from a severe case of "Low T," a weak City Manager, a new, effeminate-looking Police Chief, who refuses to enforce our nation's immigration laws & a Ward 6 Council Girl who took her Oath Of Office using a book on Marxism.

Calm Guide Sheet by Greg Karnes on Scribd

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Just one miss ?. Using the @volquartsen_firearms 22 LR Scorpion ?

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Make The University of Oklahoma Great Again!


(Let us return to the time before the “Loudmouth Communist Snowflakes” and the less than competent financial administrators arrived on campus)


NOVEMBER 23, 2014



FEBRUARY 16, 2015





NOVEMBER 22, 2014



Top 10

Taxpayer Enemies


Those Individuals Or Groups Most Intent On Penalizing Success & Achievement & Desiring A Return To The Days Of Low Economic Growth During The Jimmy Carter/Barry Obama - "Sleepy Joe" Biden Era


(in order, as of today)

The Caracas Caucus


(the Top 10 “Americans” who seem most hell-bent on destroying our jobs & economy in order to advance the cause of centralized government control over our lives and private businesses to the point where we are forced to surrender our individual liberties to the state)

The Terrorist Caucus


Those Individuals Or Groups Who

Come Across  To Me As Ambivalent Towards Islamic

Terror Activities

The “Soft On Crime” Caucus


The Top 10 Individuals Or Groups Who

Come Across  To Me As Coddling The Criminal Element At The Expense Of The Public Safety Of  Law-Abiding Citizens

The “Ugly” Caucus


The Top 10 Individuals On The Taxpayer Payroll That Strike Me As Being Just As Unattractive On The Inside As They Are On The Outside.