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Oklahoma Adopts Affordable Care Act Medicaid Expansion with Slim Majority

Oklahoma State Capitol (Jon Herskovitz/Reuters)

Oklahoma voters narrowly passed a ballot measure to extend Medicaid to thousands of poor adults, the first state to expand government-backed health insurance amid the coronavirus pandemic.

By a slim majority 50.5 percent, Oklahomans voted to expand Medicaid under the Affordable Care Act. The measure is expected to cost the state approximately $164 million a year, but will bring in an estimated $1.2 billion in funding from the federal government.

Oklahoma, which has the second-highest uninsured rate in the country, is now the fifth red state to adopt such a measure, which covers low-income adults with incomes up to roughly $17,000 a year. Amber England, the initiative’s campaign manager, has said close to 200,000 low-income Oklahoma residents could gain health insurance under the expansion.

Called “Yes on 802 Oklahomans Decide Healthcare,” the ballot initiative is an amendment to the state constitution, stymieing efforts by elected officials to restrict the program. Republican Governor Kevin Stitt has advocated for his state to adopt the Trump administration’s new proposal of a block grant for Medicaid spending, and it is unclear how the vote affects his plan.

Released in January and titled “Healthy Adult Opportunity,” the Trump administration’s block-grant proposal calls for a lump sum that the federal government would administer with individual states having significant flexibility to create enrollment rules and benefits. Under the current system, the federal government matches most state Medicaid spending. But Democrats have slammed the proposal, saying it strips benefits from those who cannot afford them for the sake of cost-cutting.

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