Oklahoma's Medicaid Expansion Is Unlike Any Other State's

After Tuesday's vote, state's Constitution will be amended
By Newser Editors and Wire Services
Posted Jul 1, 2020 7:43 AM CDT
Oklahoma's Medicaid Expansion Is Unlike Any Other State's
Voter John Parker fills in his ballot at Canadian Hills Church of the Nazarene on Tuesday, June 30, 2020, in Oklahoma City, Okla.   (Chris Landsberger/The Oklahoman, via AP)

Oklahoma voters narrowly decided on Tuesday to expand Medicaid health insurance to tens of thousands of low-income residents, becoming the first state to amend its Constitution to do so. With 100% of precincts reporting unofficial results, State Question 802 passed by less than 1 percentage point. The Oklahoman notes that only seven of the state's 77 counties voted in favor of the measure, with support coming largely from metro areas like Tulsa and Oklahoma City. Idaho, Maine, Nebraska, and Utah have all expanded Medicaid through ballot questions, but did so by amending state statutes, according to the nonpartisan Kaiser Family Foundation. Amending the Oklahoma Constitution will prevent the Republican-controlled Legislature, which has resisted Medicaid expansion for a decade, from adjusting the program or rolling back coverage, reports the AP.

State Question 802 will extend Medicaid health insurance to those earning up to 138% of the federal poverty level, which is about $17,200 for an individual or $35,500 for a family of four. Oklahoma was one of 14 states, along with neighboring Texas and Kansas, that had not expanded Medicaid under the 2010 federal Affordable Care Act. Republican Gov. Kevin Stitt and his predecessor, Mary Fallin, have opposed expansion, citing uncertainty about future costs for the state. The Oklahoma Health Care Authority has projected that about 215,000 residents would qualify for a Medicaid expansion, for a total annual cost of about $1.3 billion. The estimated state share would be about $164 million. To help fund the proposal, the Legislature is expected to increase a fee that hospitals pay from 2.5% to 4%, which would generate about $134 million annually.

(More Medicaid stories.)

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