In early February, Republican lawmakers in Oklahoma introduced a state bill and joint resolution that could shake up the future of Medicaid expansion.
The April 6 version of HB 4440 poses a state question asking whether Medicaid expansion provisions should be cut out of the state constitution. If so, that language would become statutory, allowing wider legislative discretion. Oklahomans would vote on this question Aug. 25.
The most recent version of the joint resolution proposes that, should the federal medical assistance percentage — the matching rate the federal government pays — for Medicaid expansion dip below 90%, Oklahoma would not have a constitutional duty to continue Medicaid expansion. This would still hold true even if the FMAP eventually increases.
While the proposals are directly related, only one of these changes can take effect, the joint resolution specified.
In 2020, Medicaid expansion passed in Oklahoma with a narrow margin of about 6,500 votes. The policy kicked off July 1, 2021. In 2023, the state spent $233,386,800 on expansion enrollees, according to KFF.
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