Oklahoma becomes the first state to expand Medicaid during pandemic

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Oklahoma voters on Tuesday narrowly approved a ballot initiative that will expand Medicaid to cover more low-income residents.

Oklahoma was the first state to vote on expanding Medicaid since the COVID-19 pandemic began, and Missouri is scheduled to vote on the issue in August. The vote disrupts Oklahoma Republican Gov. Kevin Stitt’s plan to make the state a test case for the Trump administration’s Medicaid block grant demonstration .

The result is another blow to the Trump administration’s healthcare agenda in an election year. The administration is pursuing a lawsuit before the Supreme Court that could invalidate Medicaid expansions across the country.

Oklahoma has the second-highest uninsured rate in the country behind Texas. The Oklahoma Health Care Authority projected that more than 200,000 new Medicaid enrollees may sign up due to the ballot initiative’s passage. Total Medicaid enrollment was 833,302 in May, according to the most recent state data.

State officials will now have to wrestle with how to pay for the expansion as they face down a budget shortfall. Stitt reversed course and abandoned plans to pursue a traditional Medicaid expansion earlier this year, and in May vetoed a bill that would have mostly paid for the first year of the expansion by raising hospital fees.

The Oklahoma Hospital Association supported the ballot initiative, and recent rural hospital closures in the state were a point advocates used to argue for the expansion.

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