On April 17, 2020, Oklahoma Governor Kevin Stitt (R) declared that State Question 802, which would expand Medicaid, will appear on the June 30 primary ballot rather than the November 3 general election ballot.

Initiatives in Oklahoma are generally placed on the next general election ballot following signature verification, but the governor may choose to call a special election or place the measure on the primary ballot. In 2018, Oklahoma Governor Mary Fallin placed State Question 788, the medical marijuana initiative, on the June primary ballot. Prior to 2018, a governor had not selected a date different from the general election for an initiative since 2005.

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 (FPL). For 2020, the FPL is $12,490 for individuals and $25,750 for a family of four. 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 low-income people and individuals with disabilities. The ACA 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 2020, 14 states, had chosen not to expand Medicaid according to the ACA.

Oklahomans Decide Healthcare is leading the campaign in support of the initiative. Oklahomans Decide Healthcare said, “Expanding Medicaid will [make] our families healthier and our economy stronger. It will deliver healthcare to those who need it, including many parents, seniors, and hardworking folks who earn less than $17,000 a year. It will also bring more than a billion of our tax dollars home from Washington, D.C. every year to create jobs, boost our economy, and keep our rural hospitals open. That’s money that 36 other states that have expanded Medicaid get, but Oklahoma has lost out on for years.” State Question 802 is supported by the Oklahoma Hospital Association, State Medical Association, Osteopathic Association, and Nurses Association.

A spokeswoman for Governor Kevin Stitt (R) said, “If SQ 802 passes, our state agencies will experience deep cuts, because the ballot measure offers no mechanism to pay for it. The governor does not support this unfunded mandate.”

In November 2018, voters in Idaho, Montana, Nebraska, and Utah decided ballot initiatives concerning Medicaid expansion and the funding of expanded Medicaid coverage. 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. In 2017, voters in Maine approved the first citizen initiative used to implement an optional provision of Obamacare.