Medicaid Expansion Wins In Red State Oklahoma

Voters in traditionally Republican Oklahoma supported a ballot measure to extend Medicaid benefits to 200,000 more low-income adults in a vote testing the popularity of the Affordable Care Act during the Covid-19 pandemic.

The vote by a narrow margin of Oklahomans to expand Medicaid under the ACA is a huge political blow to Republican Gov. Kevin Stitt, who opposed the ballot initiative and the Donald Trump White House, which just last week took more steps to try to repeal the ACA, which is now 10 years old and has expanded health coverage to more than 22 million Americans.

With 100% of precincts reporting, the Medicaid expansion measure known as Question 802 had 50.5% support, which was a lead of more than 6,000 votes out of more than 673,000 cast, according to national media tallies and the Tulsa World.

“In an election year that will be focused on health care, Oklahomans just delivered the first big win,” said Jonathan Schleifer, executive director of The Fairness Project, which worked with supporters of Medicaid expansion in Oklahoma and has helped several other states win Medicaid expansion at the ballot box.

“Voters in a deep red state became the first in the country to put Medicaid expansion in their state constitution to protect it,” Schleifer said Tuesday night. “Americans are tired of politicians ignoring the problem or worse, trying to take their health care away. Americans aren’t going to stand for that type of approach anymore.”

The Oklahoma effort to become the 37th state to expand Medicaid is just the latest momentum in Republican-leaning states where lawmakers and governors have historically blocked efforts to expand health insurance coverage to more poor Americans under the Affordable Care Act in the past. 

The vote to expand Medicaid in Oklahoma to an additional 200,000 people in the state comes as cases of the coronavirus strain Covid-19 surge and some worried that the pandemic and risk of infection hampered turnout in a state that has seen thousands lose their jobs and healthcare coverage. Medicaid expansion is expected to enable more Oklahomans to become eligible for such health coverage as unemployment rises and people lose their employer-based health benefits.

It’s the latest win for The Fairness Project, which has also been working on an August 4 ballot initiative in Missouri in hopes it follows the lead of Oklahoma and successful 2018 ballot initiatives in Nebraska, Idaho and Utah. Those states, like Maine in 2017, bypassed Republican governors and legislatures to expand Medicaid by public referendum.

The Fairness Project has said the “Yes on 802” effort would “put Medicaid expansion into the state’s constitution.”

Oklahoma and Missouri have been one of 14 remaining holdout states that have already missed out on generous federal funding of the Medicaid expansion. From 2014 through 2016, the ACA’s Medicaid expansion population was funded 100% with federal dollars. The federal government still picks up 90% or more of Medicaid expansion. It’s a better deal than before the ACA, when Medicaid programs were funded via a much less generous split between state and federal tax dollars.

“Oklahoma was an inspiring grassroots effort built on a foundation three years in the making,” Schleifer said. “What we started in Maine in 2017 has become a movement across the country. We are proving that Americans are ready to rise above partisan politics and put the health of their communities first. That was true in Oklahoma and we’re witnessing the same thing in Missouri.”