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Oklahoma Voters May Have Added Medicaid Expansion to State Constitution

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Preliminary election results show that Oklahoma voters may have approved State Question 802 — an Affordable Care Act (ACA) Medicaid expansion measure.

The measure would amend the state constitution to require state leaders to accept federal ACA Medicaid expansion funding.

The measure appeared on the ballot Tuesday. At press time, the Oklahoma State Election Board was reporting 340,279 votes in favor of the amendment measure, or 50.48% of all votes tallied, and 333,761 against.


  • Information about Oklahoma State Question 802 is available here.
  • Information about the election results is available here.
  • A health insurance group vice president’s thoughts about Medicaid expansion politics are available here.

The ACA Medicaid expansion program provides enough federal funding to cover 90% of the cost of making Medicaid available to adults under 65 who earn up to 138% of the federal poverty level, or $17,236 for an individual.


In the preliminary results tally, State Question 802 was leading by just 6,518 votes.

That tally did not include results for “provisional ballots,” or ballots cast by people who faced questions about their eligibility to vote, or about their eligibility to vote where they voted.

The election board said it expected to certify that final results sometime between 5 p.m. Friday and by the end of the day on July 7.

Even if the ballot measure succeeds, it’s not clear what that would mean for Oklahoma’s Medicaid program.

In the past, legislative conflicts and court fights have blocked, delayed or changed many state and federal health insurance rules and programs.

More on this topic

Oklahoma Gov. Kevin Stitt, R-Okla., says he wants to expand the state’s Medicaid program, but he has argued that using an off-the-shelf approach would cost the state about $164 million per year and would be too expensive. Stitt has been trying to win federal approval for “SoonerCare 2.0,” an alternative approach that would include work requirements for many adult enrollees. The proposal would also require some enrollees to pay premiums of up to $10 per month for individuals and up to $15 per month for families.

The Vote

Whatever happens to State Question 802, the preliminary Oklahoma results suggest that, in some states, the ACA Medicaid program may have a significant amount of support from Republicans and independents.

Voters voted on the State Question 802 as they were participating in Republican and Democratic primaries.

The preliminary vote results show that a total of 271,017 people cast votes in the Democratic U.S. Senate primary.

That means the number of votes in favor of State Question 802 was 69,262 higher than the number of people who participated in the Democratic primary, and that at least 10% of the votes supporting Medicaid expansion came from Republicans, independents, members of small parties, or Democrats who skipped voting in the Senate primary.

Oklahoma breaks out election results by type of vote, and the type-of-vote breakout statistics may also have implications for health policy watchers in the rest of the country.

Here’s a look at the type-of-vote results breakout:

  • Voted in person on election day: 245,227 for State Question 802 and 299,712 against (45% to 55%)
  • Voted early, in person: 18,959 for and 15,528 against (55% to 45%)
  • Cast absentee ballots: 76,094 for and 18,521 against (80% to 20%)

— Read For poor, Medicaid split creates two Americason ThinkAdvisor.

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