For many during the COVID-19 public health emergency, Medicaid coverage has been the one area of their lives where they feel a sense of control during a time filled with unemployment, housing insecurity, and health scares. Due to federal protections made possible by the Families First Coronavirus Response Act (FFCRA), people have been able to retain Medicaid coverage despite changes to their circumstances that would have otherwise triggered disenrollment. People who live in Medicaid expansion states likely feel an even greater sense of security from their Medicaid coverage because enrollees aged 18-64 can qualify for Medicaid based on income alone.

Oklahoma voters recognized the need for Medicaid expansion, particularly at the height of the COVID-19 pandemic, when they voted to pass Medicaid expansion in June 2020. Oklahoma capitalized on the timing of their Medicaid expansion implementation because as part of the American Rescue Plan Act (ARPA), they were able to obtain heightened federal funds as was promised to newly expanded states. As a result, legislators were able to fund coverage of the expanded population without raising taxes. Prior to Oklahoma’s implementation of Medicaid expansion, the Center on Budget and Policy Priorities estimated Oklahoma would receive $860 million more in federal funds. We know that our partners in the remaining non-expansion states are clamoring for the confirmed savings to Oklahoma’s state budget so we will continue to watch closely for this data.

The Oklahoma Policy Institute (OK Policy), a non-partisan, non-profit organization focused on advancing equitable and fiscally responsible policies, created a Year 1 Report to celebrate and capture the gains from Medicaid expansion and its impacts on the state since the implementation of Medicaid expansion one year ago. This blog serves to uplift this important report and all of the ways that Oklahomans have benefited from implementing Medicaid expansion. Here are some of the major takeaways from OK Policy’s report:

  • Decreased number of uninsured in the state. As of April 25, 2022, Medicaid expansion has helped more than 280,000 Oklahomans gain Medicaid coverage and has decreased the uninsured rate by 33%. Medicaid coverage has been especially important during the public health emergency as people have needed to access health care to treat potential COVID-19 diagnoses in addition to other conditions.
  • Reduced racial disparities in uninsurance. Medicaid expansion decreased the uninsured rate across all racial and ethnic groups, for which data is available. Across the country, communities of color experience disproportionately higher rates of uninsurance due to racist policies and practices, and research suggests that Medicaid expansion has reduced racial disparities in access to care and health outcomes.
  • Prevents Lapse in Coverage for Individuals Transitioning from Incarceration. Most individuals leaving prison have little to no income and, therefore, qualify for Medicaid under Medicaid expansion. This is particularly important because the period around release from incarceration is a critical time to establish continuity of medical care and access necessary services. OK Policy reports that this access to care immediately upon release keeps people healthy and reduces the likelihood of returning to prison. The Oklahoma Department of Corrections facilitates this process by educating eligible individuals about Medicaid expansion and assisting in their enrollment at the time of release.
  • Strengthened the health care workforce. Hospitals in states that have expanded Medicaid are 84 percent less likely to close than hospitals in non-expansion states. As 55 percent of Oklahomans live in urban areas and 45 percent live in rural areas, it’s critical that the state help to bolster hospital finances to continue meeting the needs of Oklahomans. This not only affects hospital sustainability, but also ensures that health care workers maintain their jobs.
  • Successful Medicaid expansion implementation was made possible by collaboration. “Health Navigators at Legal Aid Services of Oklahoma and Opportunities Industrialization Center (OIC) of Oklahoma County, Tribal entities, and enrollment assisters from community organizations statewide… were instrumental in decreasing consumer confusion and helping more people find coverage for which they are eligible.” The coordinated effort helped to make the implementation of Medicaid expansion in Oklahoma successful, both in terms of outreach to communities and to underscoring the importance to legislators.

We applaud Oklahoma for successfully implementing Medicaid expansion and for all of the work that OK Policy does to ensure that Oklahoma legislators understand the importance of Medicaid expansion in their constituents’ lives as well as uplifting Medicaid expansion coverage for those who are eligible.