OKLAHOMA CITY (CN) — Oklahoma primary voters Tuesday narrowly approved an expansion of Medicaid under the Affordable Care Act, rejecting arguments by Republican state leaders that the measure will result in deep budget cuts for state agencies.
State Question 802 passed with 50.51% of 665,888 total people voting “Yes” and 49.49% voting “No,” with 1,927 of 1,948 precincts reporting late Tuesday evening. Absentee “Yes” votes heavily outnumbered “No” votes as they were announced shortly after polls closed but the gap closed considerably through the evening as more “No” votes were placed on Election Day in rural precincts.
SQ 802 amends the Oklahoma Constitution to expand Medicaid health insurance for residents between the ages of 18 and 65 with income up to 138% of the federal poverty line. The new limit for Medicaid coverage in Oklahoma is now $17,236 for individuals — $35,535 for a family of four.
The U.S. Supreme Court ruled in National Federation of Independent Business v. Sebelius in 2012 that the federal government cannot withhold money from states that refuse to expand Medicaid, effectively making the expansion optional. Oklahoma was one of 14 Republican-controlled states that had declined to expand Medicaid under Obamacare as of this year. The federal government will now pay 90% of the cost of the expansion in Oklahoma.
The nonprofit group Yes on 802 side-stepped the Republican-controlled Oklahoma Legislature’s refusal to opt-in by collecting over 310,000 signatures last year to put SQ 802 on the ballot. Only 177,958 signatures were required.
Amber England, executive director of Yes on 802, thanked the group’s volunteers who “feverishly campaigned” to make the signature drive a success. She noted that over 140,000 requests were made for absentee ballots for the election due to the ongoing Covid-19 pandemic.
“I think it shows we made our case early and folks were ready to vote on State Question 802,” she said during the group’s online watch party late Tuesday. “I know that so many of our supporters are home tonight and want to be with us and celebrating — regardless of the outcome — something the politicians would not do.”
Tulsa Public Schools board member Suzanne Schreiber told supporters that getting children’s basic medical care needs met under the Medicaid expansion is critical for getting their mental health and early childhood education needs met, too.
“We have not had the access that other states have had the past 10 years and our outcomes have shown in,” she said.
Republican Governor Kevin Stitt has insisted even with the federal government footing 90% of the bill, Oklahoma will still be on the hook for $200 million under SQ 802. Coupled with lost revenue from the pandemic’s stay-at-home orders, he projects a $1 billion shortfall for next year’s state budget.
“State Question 802 is not good for Oklahoma, I will be voting no,” Stitt said on June 23. “The only way to get $200 million is to raise taxes or to cut services somewhere else like education, first responders or roads. As governor, I’m not going to raise taxes.”
Stitt noted Oklahoma has the “largest” state constitution in the country, giving the state “zero flexibility” on Medicaid expansion. He said the measure adds another 200,000 people onto the 800,000 people already on Medicaid in Oklahoma.
Stitt proposed an alternative to SQ 802 in January, calling it SoonerCare 2.0. The legislation proposes 90% of funding from the federal government, as well, but would charge co-payments, monthly premiums of up to $15 for families and impose work and education requirements.
Yes on 802’s England panned the proposal, saying SoonerCare 2.0 is an attempt at capping the care Oklahomans would receive and would cost the state billions of dollars.
“In fact, the nonpartisan Commonwealth Fund found that Oklahoma would receive 17.2% less federal funding under the governor’s approach than under State Question 802,” she said in March. “Without the protections built into State Question 802, we’re betting the health of Oklahomans on the whims of politicians who can restrict the care Oklahomans receive in years to come.”
The next state to vote on opting-in on Medicaid expansion is Missouri on Aug. 4. Maine was the first state to opt-in through voters in 2017 when a nearly-identical ballot measure passed. Voters in Idaho, Montana, Nebraska and Utah passed similar measures one year later.