Oklahoma Supreme Court Allows Medicaid Expansion Ballot Initiative

Published July 24, 2019

The Oklahoma Council of Public Affairs argued the petition language inaccurately described what the measure would do and that Medicaid expansion would violate the state’s constitution by ceding too much power to the federal government. Under expansion, the federal government would determine Medicaid eligibility and funding would be at the discretion of Congress and the president.

To get the initiative on the 2020 ballot, supporters will have to collect 178,000 signatures in 90 days. The Oklahoma Secretary of State will determine when signature gathering can begin.

Thirty-six states and the District of Columbia have adopted Medicaid expansion under the Affordable Care Act (ACA). Ballot initiatives to expand Medicaid have succeeded in the four states where they took place, Idaho, Maine, Nebraska, and Utah.

Gov. Kevin Stitt and Republican legislators oppose Medicaid expansion and promise to present a plan of their own to address the state’s health care problems.

Big Money Behind Drive

Oklahoma’s Medicaid population has doubled in the past 20 years, with more than one million residents now enrolled in the program. Proponents of expansion under the ACA say it will bring in almost $1 billion in new federal funds and provide health coverage to many of the 16 percent of Oklahomans who go without insurance.

There will be a huge, well-financed push to get voters to approve expansion, says Byron Schlomach, director of the 1889 Institute.

“Now that the Oklahoma Supreme Court has given yet another arbitrary and ill-considered ruling by dismissing obvious problems with the initiative petition, I have no doubt Medicaid expansion will make it to Oklahoma’s ballot in 2020,” said Schlomach.

“The petition process could be one of the most expensive ever, mainly because the moneyed interests pushing the initiative—nonprofit hospitals—have such deep pockets despite their constant prevarications to the legislature claiming otherwise.”

Expansion does not concentrate on helping the truly needy, says Schlomach.

“Medicaid expansion will enrich the already very wealthy, so little of the money will circulate in Oklahoma,” said Schlomach. “Little to nothing is done to check eligibility now, so fraud will only grow. And as has been demonstrated in Arizona and Colorado, health care prices will only rise all the more.

“My hope is that we can convince Oklahomans of how useless Medicaid expansion would truly be,” said Schlomach.


Jake Grant ([email protected]writes from Alexandria, Virginia.