OKLAHOMA CITY – Oklahoma voters decided Tuesday to tighten 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 venues reporting unofficial results, the state question 802 passed by less than 1 percentage point. The question worked well in metropolitan areas, including Oklahoma City and Tulsa, but overwhelmingly opposed in rural counties.
Idaho, Maine, Nebraska and Utah have expanded Medicaid through questions on the ballot, but they did so by amending state statutes, according to the Kaiser Family Foundation.
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Amending the Oklahoma Constitution will prevent the Republican-controlled Legislature, which has resisted Medicaid expansion for a decade, toying with the program or reducing coverage. Missouri voters will also decide on a constitutional amendment on August 4.
State question 802 will extend Medicaid health insurance to those who earn up to 138% of the federal poverty level, which is approximately $ 17,200 for an individual or $ 35,500 for a family of four.
Oklahoma was one of 14 states, along with neighbors in Texas and Kansas, that had not expanded Medicaid under the federal Affordable Care Act of 2010. Republican Governor Kevin Stitt and his predecessor, Mary Fallin, have opposed expansion, citing uncertainty about future costs to the state.
"We have a billion dollar deficit next year," Stitt said recently at a forum organized by Americans for Prosperity, a conservative political advocacy group that opposes the measure. The state would have to "raise taxes or cut services elsewhere like education, lifeguards, or highways and bridges" to reduce additional Medicaid costs, he said.
After years of legislative inaction on health insurance proposals, supporters of the Medicaid expansion launched a petition for initiative last year to include the measure on the ballot and collected a record number of signatures. The plan was backed by several politically powerful groups, including chambers of commerce, medical commerce groups, the Oklahoma Education Association, and the Oklahoma Conference of Churches.
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Some Republican opposition to Medicaid expansion has eroded in recent years, particularly in rural areas where hospitals have suffered financial problems or have closed.
Kevin Penry, a retired Republican pastor from Edmond, said he had to buy expensive insurance in the federal market before going to Medicare last month, which "really made me feel for people who are in a difficult financial situation." . He said he voted in favor of expansion.
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The Oklahoma Health Care Authority has projected that approximately 215,000 residents would qualify for a Medicaid expansion, for a total annual cost of approximately $ 1.3 billion. The estimated state participation would be approximately $ 164 million. But those numbers could be considerably higher given the number of Oklahomans who have lost their jobs and job-related health insurance due to the economic shutdown amid the coronavirus pandemic.
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. Stitt vetoed that measure earlier this year.