Oklahoma voters Tuesday will decide whether to expand Medicaid via ballot initiative just 10 days after President Trump spoke in Tulsa at a sparsely attended campaign rally designed to revive his re-election bid.
A vote this week by Oklahomans to expand Medicaid under the Affordable Care Act would be seen as a huge blow to the Trump administration, which has made repealing the law a signature part of its first three years in office. Trump didn’t mention the ACA or its Medicaid expansion when he spoke June 20 in a Bank of Oklahoma Center with thousands of empty seats.
But the Trump White House and Republicans including Oklahoma Gov. Kevin Stitt are opposed to the ACA and the ballot measure, which would put Medicaid expansion into the state’s constitution. Just last week, the Trump administration took more steps to once again try to repeal the ACA, which is now 10 years old and has expanded health coverage to more than 22 million Americans.
The vote in Oklahoma comes as cases of the coronavirus strain Covid-19 surge and some worry that the pandemic and risk of infection could reduce turnout in a state that has seen thousands lose their jobs and healthcare coverage. Medicaid expansion could enable more Oklahomans to become eligible for such health coverage as unemployment rises and people lose their employer-based health benefits.
“For the first time since the coronavirus hit, health care will be on the ballot, and the stakes couldn’t be higher,” said Jonathan Schleifer, executive director of The Fairness Project, which is working with supporters of Medicaid expansion in Oklahoma and has helped several other states win Medicaid expansion at the ballot box.
Some see rising cases of Covid-19 as a wild card that could help win an expansion of Medicaid to about 200,000 Oklahomans or potentially depress voter turnout.
“Oklahoma has the chance to deliver life-saving care to essential workers who have been abandoned for far too long, reduce racial health care disparities, and keep rural hospitals open,” Schleifer said. “In an election year when health care will dominate the debate, voters in one of the deepest of red states are on the verge of putting Medicaid expansion into their state constitution to make sure that politicians can never take their health care away.”
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.
But Republicans and conservative groups worried that expansion could win in Oklahoma earlier this month ramped up a campaign against the State Question 802. A political action committee was also formed by Republican leaning groups to derail the effort to expand Medicaid.
Meanwhile, supporters of Oklahoma Medicaid expansion have been working with The Fairness Project, which has also been working on a November ballot initiative in Missouri in hopes those states will follow the lead of 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 have 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.
If all remaining 14 holdout states expanded Medicaid, about 4.7 million uninsured adults could gain eligibility by next year, according to a new Kaiser Family Foundation analysis. “That figure includes an estimated 2.8 million adults who already were uninsured prior to the coronavirus pandemic and would fall in the ‘coverage gap’ – meaning they have incomes too high to qualify for Medicaid but too low for ACA marketplace subsidies,” the Kaiser Family Foundation said last week.