On June 30, 2020, the citizens of Oklahoma narrowly approved a state question to expand Medicaid in the state. State Question 802 passed with 50.5% of voters’ support and is predicted to allow at least 200,000 Oklahoma adults to become eligible for the program. It will provide coverage for those aged 18-64 who are not already covered and whose annual income is at or below 133% of the federal poverty line. The measure will insert Medicaid expansion into the state constitution and prevents the state from creating additional restrictions for eligibility than what are currently in place. This will make it difficult for state leaders to make changes to the program to later restrict enrollment, like adding additional work requirement provisions or premiums to the eligibility requirements.
The passed measure requires the state to submit expansion paperwork to the federal government within 90 days for approval to implement expansion by July 1, 2021. Under the program, the federal government will cover 90% of costs, and Oklahoma will be responsible for the remaining 10%. The Oklahoma Health Care Authority has estimated that Oklahoma’s cost of expansion will be $164 million annually.
Oklahoma’s governor, Kevin Stitt, was the first governor to seek a waiver from CMS to enact block grants in Medicaid under new guidance released by the Trump Administration earlier this year. This would have given the state a lump sum payment from the federal government instead of flexible funding dependent on enrollment. Gov. Stitt must now decide whether to withdraw the waiver, as it will face legal challenges if approved by CMS.
Oklahoma will join the 36 other states that have expanded the Medicaid program.