Changing the state constitution to defeat Republican opposition to insuring the poor

Big Win for Medicaid Expansion in Oklahoma Referendum

Yes on 802 Exec. Ambler England celebrates the victory of a state referendum to mandate expansion of Medicaid in the Red state of Oklahoma.

(This article is a joint publication project of ThisCantBeHappening! and

A campaign cobbled together on a tight deadline required by Oklahoma’s strict referendum law, battled and won a narrow victory last Tuesday to amend the state’s constitution and mandate the expansion of Medicaid, overcoming the opposition of a Republican governor and legislature and major out-of-state funding for the opposition.

By a narrow but victorious margin of 50.48% to 49.52%, Oklahoma voters said they wanted their state to join the federal Medicare expansion program that was an integral part of the Obama administration’s Affordable Care Act (ACA), popularly known as Obamacare. With passage of the referendum, only 13 states, all of them Republican and located in the nation’s Southeast and Midwest, continue to refuse to expand Medicaid eligibility for their residents.

In conceding defeat, Oklahoma’s Republican Gov. Kevin Stitt announced that the government would act to implement the expansion, which will extend Medicaid coverage to an estimated 200,000 additional Oklahomans by raising the income eligibility cutoff from the current federal poverty level of $12,490 for an individual and $25,750 for a family of four to 138% of the federal poverty level, which would be $17,236 for individuals and $35,535 for a four-member family. 

Amber England, who headed the Yes on 802 campaign, told Tarbell, “Oklahomans had the courage to stand up and do what the government has been afraid to do for over a decade.” 

England said that the passage of the referendum measure, besides extending Medicare coverage to many people, will also save struggling rural hospitals. This is because many poor but uninsured residents of the state who until now didn’t before qualify for Medicaid but also didn’t have the money to buy even subsidized private insurance under the ACA, were having to get themselves admitted as non-paying charity patients either at local smaller hospitals or at the ER rooms of large urban hospitals that could be 50 or more miles away. Now these patients will be able to go to local hospitals and have their care funded by Medicaid.

Much of the Republican opposition in many Red states across the country to the expansion program option has been ideological. Republican members of Congress from these states had long opposed Obama’s ACA plan, and opposing Medicaid expansion was a part of that. Republican officials in Oklahoma and the other 13 states that are still denying the expanded program to their struggling residents have insisted the problem is financial, not ideological.  Under the federal expansion provisions, Washington covers 90 percent of the cost of expanding coverage, but these Republican state officials point out that their states still have to fund the other 10 percent.

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