Oklahoma: As if work reporting won't cause enough damage, GOP moves to kill off Medicaid expansion entirely

via NPR:

In 2020, Oklahoma voters passed Medicaid expansion, adding more people to Soonercare. Republican lawmakers are advancing proposed constitutional changes to reverse that vote: House Bill 4440 and House Joint Resolution 1067.

If approved, both state questions would give lawmakers the ability to adjust or reverse Oklahoma’s expanded Medicaid eligibility without a majority vote of approval by Oklahomans, with one acting as a failsafe in case the other is unsuccessful during the Aug. 15 primary runoff.

...Both measures passed the Senate Rules Committee along party lines on Monday.

Democrats say the process to approve the measures in the Senate feels ‘intentionally chaotic.’

Expanded Medicaid eligibility extends government-subsidized health coverage to adults aged 19-64 with incomes up to 138% of the federal poverty level. Today, adults made eligible by the expansion vote account for just over a fifth of all Oklahomans enrolled.

According to official data from the Centers for Medicare & Medicaid Services (CMS), Oklahoma had around 240,000 residents enrolled in Medicaid via ACA expansion as of last June, and as of March 2026 this had dropped slightly to 233,500 via the Oklahoma Health Care Authority.

Congress’s “One Big Beautiful Bill” requires states to re-verify eligibility for most Medicaid expansion adults every six months instead of annually, and to implement new work requirements.

...Oklahoma’s Medicaid expansion rules are enshrined in the state constitution, which means lawmakers can’t just make the money-saving changes they want to within the regular legislative process.

They have to ask the voters who voted for expansion in the first place. So, HB 4440, if approved on the Senate floor and signed by the governor, would add a state question to the Aug. 25 primary runoff ballot. Then, Oklahomans could vote to remove Medicaid expansion from the constitution and add it to the state’s statutory code, allowing lawmakers to make changes – or completely repeal the provisions – at their own discretion.

HJR 1067 was drafted with different language but would have a similar effect if certain stipulations are met. It proposes a state question asking if voters would be willing to absolve the state from the responsibility to fill in gaps in Medicaid expansion funding if the federal government pays anything less than 90% of the total costs to do so.

If passed by the legislature and signed by the governor, the measure would appear on the November general election ballot. But it would only go to a vote of the people if HB 4440 fails to pass.