Oklahoma Expands Medicaid

Kind of a big deal because Oklahomans rejected Trump’s Medicaid and Republican block grant-program which would be more vulnerable to cuts of Federal funding.  It is unfortunate Oklahoma did not get on board with the ACA Medicaid expansion as 100% of the costs of the Medicaid expansion from 2014 – 2016 and 90% there after. I could never understand the cold-hearted logic of states in not expanding Medicaid. Much of the costs of expanding Medicaid now would have been covered.

In spite of Oklahoma Governor Kevin Stitt’s plan to make the state a test case for the Trump administration Medicaid block grant program, Oklahoma voters narrowly approved its own initiative to expand Medicaid for low income people. In theory, the state will be in the driver’s sit (mostly) in deciding how much money it will allocate to the program rather than the Federal government.

Oklahoma is the the first state to expand Medicaid during the Covid pandemic. Oklahoma has the second-highest uninsured rate in the country following up Texas who is #1 in both uninsured and the numbers of new Covid cases. The State Question 802 initiative was passed by a margin of less than 1 percentage point amongst voters. It was strongly supported in metropolitan areas such as Tulsa and Oklahoma City and widely opposed in rural counties. While Idaho, Maine, Nebraska and Utah expanded Medicaid through ballot questions and amended state statutes, Oklahoma State Question 802 amended the Oklahoma Constitution which prevents  the Republican-controlled Legislature from altering  the Medicaid program or rolling back coverage.

At an “Americans for Prosperity” forum, Governor Stitt said “We will have a $billion shortfall next year. The state will have to consider raising taxes or cut to such services as education, first responders, or roads and bridges” in order to cover the additional costs of Medicaid.

Looking back, the expansion of Medicaid and also the ACA mandate would increase the numbers of people having healthcare insurance which would be a boon to healthcare insurance companies. The ACA tax on healthcare insurance companies (who would benefit greatly from the new business) was meant to provide additional funds to cover the costs of healthcare. Instead, the Oklahoma plan will increase the fees on hospitals from 2.5% to 4%.  There is more to this issue and I will tackle it another time.