Oklahomans to decide on SQ 802 June 30
OKLAHOMA CITY – An expansion of Medicaid services to more low-income Oklahomans will be submitted to voters statewide on June 30.
Gov. Kevin Stitt, an avowed opponent of SQ 802, issued a proclamation last Friday to place the measure on the statewide primary election ballot. The measure would add a provision to the Oklahoma Constitution requiring the state to expand Medicaid coverage.
Medicaid eligibility would extend to adults between ages 18 and 65 whose income is 133% or below the federal poverty level. Because the Affordable Care Act (ACA) includes a 5% income disregard, SQ 802 would effectively expand Medicaid to those whose incomes are below 138% of the federal poverty level (FPL).
The following table displays the federal poverty level income numbers as of 2020.
The proposal would extend Medicaid coverage to approximately 200,000 more Oklahomans, officials claim. Neary 808,000 Oklahomans – 67% of the children and 33% adults – were enrolled in SoonerCare (Oklahoma’s Medicaid program) in March, according to the Oklaho- ma Health Care Authority (OHCA).
OKLAHOMA IS ONE OF 14 STATES THAT HAVE SPURNED EXPANSION
Medicaid expansion was authorized by the ACA and became available to states in 2014. In 2018, the federal government financed 94% of the costs of state Medicaid expansion. For 2020 and subsequent years, the federal government was set to cover 90% of the costs.
Consultants for the governor have estimated the cost of Medicaid expansion to Oklahoma would be around $150 million annually. The federal government would cover the other 90%, which would be approximately $1 billion annually. Oklahoma is one of 14 states that have not adopted expansion.
On March 16 Stitt unveiled his own plan, dubbed SoonerCare 2.0, which directed the OHCA to apply for a federal waiver that would, among other things, enact a per-person expenditure cap, charge premiums for the Medicaid expansion population, and impose “community engagement” that would require new Medicaid recipients to work, volunteer, or attend school for at least 80 hours per month.
The ballot title for SQ 802 expressly decrees that the state “cannot create additional restrictions” – such as insurance premiums and work requirements – “that make it more difficult to qualify for expanded Medicaid coverage than it is to qualify for the Medicaid program currently in place.”
Imprinting Medicaid expansion in the state Constitution would limit the state Legislature’s ability to modify it.
SQ 802 WOULD BENEFIT OKLAHOMANS, HOSPITALS
The only way to ensure that nearly 200,000 more Oklahomans “receive the care they need” is to expand Medicaid by voting “yes” on the proposed constitutional amendment, “Yes On 802” Campaign Manager Amber
England said in a statement. “[H]ardworking Oklaho- mans need access to health- care and the ability to keep our rural hospitals open,” she said. “In recent weeks, we’ve all come to appreciate just how important it is to be able to see a doctor and have healthcare that can’t be taken away. The stakes could not be higher for our friends, family, and neighbors who work at lower-paying jobs and for rural residents who need a ‘yes’ vote to keep their hospitals open.”
That’s why doctors, nurses, and patients throughout Oklahoma “set a record for the most signatures ever collected for a ballot measure in the state’s history,” England said.
Campaign supporters collected more than 313,000 signatures last year, and the Secretary of State’s office verified 299,731 of them – far more than the 177,958 needed for ballot status.
“We have 70 days to get our message out and make sure Oklahomans have the information needed to make this important decision,” En- gland said.
But setting an election date “isn’t enough,” she continued. “No one should have to choose between their safety and their right to vote; therefore, Governor Stitt, the Oklahoma Legislature and the State Election Board should take immediate action to ensure that Oklahomans can freely and safely exercise their right to vote in June...”
OPPONENTS CITE COSTS, ‘STRINGS’
The Oklahoma Council of Public Affairs (OCPA) filed a protest challenging the ballot summary of SQ 802, but the state Supreme Court ruled 6-3 in June of 2019 that the gist is clear and accurately informs petition signers of what the amendment intends to do.
OCPA policy research Fellow Curtis Shelton wrote that approval of Medicaid expansion would mean more federal control. There is “no guarantee” that the federal government won’t impose “additional requirements in exchange for these federal dollars,” he asserted.
There are “more than 1,800 regulatory strings attached to Medicaid dollars that states must abide by in order to receive” the funding, he wrote.
Similarly, OCPA policy research Fellow Kaitlyn Finley wrote last year that states which expand their Medicaid programs “may face budget shortfalls due to higher-than-expected costs and scheduled cuts in federal matching contributions.”