Oklahoma City, OK — Rising Medicaid costs are becoming one of the biggest challenges facing Oklahoma lawmakers as they work to finalize the state budget for the upcoming fiscal year.

Senator Brent Howard of Altus, who represents District 38 covering southwest Oklahoma including Beckham and Washita counties, said the Senate Appropriations Committee is closely examining the growing expense of SoonerCare, Oklahoma’s Medicaid program, which now covers roughly one in four residents.

Since voters approved State Question 802 in 2020 to expand Medicaid, costs have steadily climbed. The expansion initially cost the state about $162 million in its first year. That number has since increased to approximately $250 million annually. The Oklahoma Health Care Authority has also requested an additional $42 million for the next fiscal year to account for a 22% increase in program growth and higher utilization among expansion enrollees.

Costs are also rising within the traditional Medicaid population, which includes seniors, pregnant women, children and individuals with disabilities. Officials expect about 10% growth in that group, adding an estimated $182 million in expenses next year. Altogether, the Oklahoma Health Care Authority has requested a total budget increase of $494 million.

While the federal government currently covers 90% of the cost for Medicaid expansion, Howard noted there is no guarantee that level of support will continue. If federal funding decreases, the state would be responsible for covering the difference, placing additional strain on Oklahoma taxpayers.

Complicating the issue is the fact that Medicaid expansion is written into the Oklahoma Constitution, limiting the Legislature’s ability to make changes. Some lawmakers are now exploring ways to create more flexibility. The Oklahoma House has advanced a joint resolution that would allow adjustments to the program if federal funding levels change. The Senate is expected to consider the measure in the coming weeks. If approved, the proposal would go before voters.

Medicaid expansion currently covers adults earning up to 138% of the federal poverty level, or about $21,597 annually for an individual. While some states have lowered that threshold, Oklahoma is required to maintain it under the current constitutional language.

Howard said moving Medicaid expansion from the constitution into state law could give lawmakers more control to manage costs and prioritize coverage for those most in need.

As budget discussions continue during what officials describe as a tight fiscal year, lawmakers warn that unchecked Medicaid growth could impact funding for other priorities, including education, infrastructure and public safety.

Residents wishing to contact Senator Howard can do so by mail at the State Capitol, 2300 N. Lincoln Blvd., Room 427, Oklahoma City, OK 73105, by email at Brent.Howard@oksenate.gov, or by phone at (405) 521-5612.

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