- Oklahoma on Thursday became the 37th state to implement Medicaid expansion, in a move that's made up to 190,000 low-income Americans newly eligible for the safety-net insurance program.
- The Sooner State began accepting applications for Medicaid in June. To date, almost a quarter of a million have applied for and been found eligible for the newly expanded coverage, according to the Oklahoma Health Care Authority.
- Due to the American Rescue Plan passed in March, the state is eligible for increased federal funding for its Medicaid program, estimated to be nearly $500 million over two years. On Thursday, HHS Secretary Xavier Becerra congratulated the state on the expansion, and urged the 13 remaining states that have yet to expand Medicaid to reconsider.
Following ballooning enrollment during the coronavirus pandemic, Medicaid is now the largest source of coverage in the U.S., covering roughly one in four Americans.
About one million people, or 25% of the state's total population, are already enrolled in Medicaid. But due to the state's expansion of the safety-net insurance program, up to 190,000 additional individuals between the ages of 19 to 64 with an income of $35,245 for a family of four, or at or below 133% of the federal poverty line, are newly eligible for coverage.
"I encourage the remaining 13 states to look at the opportunities included in the American Rescue Plan and join us, so that every person eligible can get covered," Becerra said in a statement on the news. Boosting the Medicaid program is a key prong of the Biden administration's health policy agenda.
In addition to the 90% federal matching funds available under the Affordable Care Act for the expansion population, the ARP incentivizes states that have yet to expand coverage through Medicaid by offering a five percentage point increase in the federal match rate, for two years.
However, the more generous funding has yet to incentivize the holdout states — Alabama, Florida, Georgia, Kansas, Mississippi, Missouri, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin and Wyoming — to expand Medicaid. Oklahoma voted to expand its program last June despite fierce opposition from its Republican governor and legislature, before the additional incentives were codified into law.
Oklahoma was the fifth state to approve the expansion at the ballot box.
Another such state, Missouri, narrowly approved a ballot initiative last year to expand Medicaid. But its Republican-led state legislature decided not to include it in a budget bill signed in May by Governor Mike Parson, also a Republican. Parson then withdrew the state's expansion request from CMS over a lack of funding, though the expansion was expected to be budget-neutral or even save the state money, according to a Washington University in St. Louis analysis.
Just last week, a circuit judge ruled the ballot initiative didn't actually require the state to appropriate funds for expansion, following a lawsuit seeking to force the move. The case will next appear before the Missouri Supreme Court.
More than 230,000 low-income Americans in Missouri would gain access to coverage if expanded.