What Neighboring States Can Tell Us About Medicaid Expansion in Oklahoma

Update: On Tuesday, July 30, Oklahoma voters approved Question 802, the ballot measure to expand Medicaid in the state. The vote means that Medicaid expansion will take effect in July 2021 and that an estimated 250,000 additional Oklahomans will soon be eligible for coverage through Medicaid. Oklahoma is the 37th state to have expanded Medicaid eligibility since the Affordable Care Act was passed in 2010.


This month, Medicaid expansion is on the ballot in Oklahoma.

Medicaid plays a critical role in the health and well-being of Oklahomans, covering more than 820,000 residents, including children, older adults, people with disabilities, and veterans. As of 2019, Oklahoma had the second-highest rate of uninsured (14.2%) in the country. COVID-19 has further increased the number of uninsured Americans throughout the country, including in Oklahoma, which saw a 2,507% increase in unemployment claims from June 2019 to June 2020.

Recent projections estimate that 250,000 currently uninsured adults would gain eligibility for Medicaid if Oklahoma were to expand the program. In the past few years, nearby states have expanded Medicaid and are showing significant improvements for the health and financial security of thousands of Americans.

Expanding Coverage to Vulnerable Populations

Arkansas was one of the earliest adopters of Medicaid expansion, with the state’s program officially expanding in January 2014. Expanding Medicaid helped Arkansas cut its uninsured rate in half, expanding coverage to hundreds of thousands of residents. The uninsured rate fell from 22.5% in 2013 to nearly 8% in 2019. In total, more than 320,000 Arkansans gained coverage through Medicaid expansion from 2013 to 2018.

Colorado, another early adopter of Medicaid expansion, reduced its uninsured rate from 14.3% in 2013 to 6.5% in 2019. The state estimates that more than 380,000 of the 1.3 million Coloradans currently enrolled in Medicaid received coverage through expansion.

With nearly 550,000 Oklahoma residents uninsured as of 2018, Medicaid expansion represents a critical opportunity to extend comprehensive health coverage to vulnerable populations.

Improving Health Outcomes

As many of the individuals eligible for Medicaid coverage under expansion have complex health needs, the program’s innovative health solutions have the potential to improve health outcomes significantly.

In Louisiana, in just the first year since they expanded Medicaid, more than 100,000 patients received preventive care, and more than 15,000 patients received breast cancer screenings. Further, more than 2,600 people have been diagnosed with diabetes, while nearly 10,500 have received colon cancer screenings.

Spurring Economic Growth

While providing quality health coverage is the core mission of Medicaid, expanding the program has also proven to provide a significant boost to state budgets and local economies.

In Louisiana, expanding their Medicaid program in 2016 helped promote economic activity and generate job growth, particularly in the health care industry. The Louisiana Department of Health estimates that Medicaid expansion directly created more than 1,000 new jobs and generated $4 billion in new revenue for health care providers.

This tracks with the experience in Arkansas, where Medicaid expansion is expected to save the state $444 million from 2018-2021.

The health and economic benefits of Medicaid expansion are clear, and the experience of early-adopting states has recently led other neighboring states, including Nebraska and Utah, to approve and begin implementing their own expansion programs. As voters in Oklahoma consider expanding this vital program, the Modern Medicaid Alliance is committed to raising awareness about the tremendous benefits of Medicaid and its role as a core part of the country’s social safety net.