Proponents of Oklahoma State Question 802—an initiative to expand Medicaid in Oklahoma–reported submitting 313,000 signatures on October 24, 2019, to qualify the measure for the 2020 ballot. Oklahomans Decide Healthcare needs a total of 177,958 valid signatures to qualify its measure for the ballot. The Secretary of State’s office is set to begin a physical signature count on October 30, 2019.

 

State Question 802 would expand Medicaid in Oklahoma under the Affordable Care Act (ACA), also known as Obamacare. It would provide Medicaid coverage for certain low-income adults between 18 and 65 with incomes below 133% of the federal poverty level. Because the ACA includes a 5% income disregard, this measure would effectively expand Medicaid to those with incomes below 138% of the federal poverty level.

 

Medicaid is a government program that provides medical insurance to groups of people with income below certain levels and individuals with disabilities. The Affordable Care Act (ACA), also known as Obamacare, provided for the expansion of Medicaid to cover all individuals earning incomes up to 138% of the federal poverty level. In 2012, the U.S. Supreme Court ruled in NFIB v. Sebelius that the federal government could not withhold funds from states that refused to expand Medicaid. The ruling had the practical effect of making Medicaid expansion optional for states. In 2018, the federal government financed 94% of the costs of state Medicaid expansion. For 2020 and subsequent years, the federal government was set to cover 90% of the costs.

 

As of 2019, a total of 36 states and Washington, D.C., had expanded or voted to expand Medicaid, while 14 states had not.

 

In 2017, voters in Maine approved a ballot initiative to expanded Medicaid. The measure was the first time a citizen initiative to expand Medicaid appeared on any statewide ballot.

 

In November 2018, voters in Idaho, Montana, Nebraska, and Utah decided ballot initiatives concerning Medicaid expansion and the funding of expanded Medicaid coverage. The Idaho and Utah measures were approved by voters and later altered by the states’ legislatures. The measure in Nebraska was approved, and the measure in Montana was defeated. In January 2018, voters in Oregon approved Measure 101, thereby upholding 2017 legislation to provide funding for the state’s portion of costs for expanded Medicaid coverage through a tax on healthcare insurance and the revenue of certain hospitals.

 

An initiative to expand Medicaid was filed in Missouri targeting the 2020 ballot. To qualify, proponents must submit 160,199 valid signatures by May 3, 2020.

 

A total of 80 measures appeared on the statewide ballot in Oklahoma from 1996 to 2018. Of this total, 77.5% (62 of 80) were approved, and 22.5% (18 of 80) were defeated.