OKPOLICY.ORG
Medicaid – known in Oklahoma as SoonerCare – is the health backbone for nearly a million Oklahomans: children, working parents, people with disabilities, and seniors. But under the “One Big Beautiful Bill,” also known as H.R. 1, that foundation is beginning to crack. The new law forces states to constantly re-verify Medicaid eligibility, burying families in red tape that few can realistically keep up with. Thousands of Oklahomans are now at risk of losing their coverage – not because they no longer qualify, but because they miss a form, a phone call, or a letter in the mail.
Endless paperwork and shorter deadlines means more Oklahomans falling through the cracks
H.R. 1 would require states to recheck eligibility far more frequently, creating what experts call churn – the cycle of people losing and re-enrolling in coverage over minor administrative issues. Even small mistakes – an outdated address, a missed notice, or an unreliable internet connection – could cause someone to lose coverage despite remaining fully eligible.
These new administrative hurdles come alongside work-reporting requirements, which would have a chilling effect across the program. Confusing rules, inconsistent notices, and limited access to online reporting portals make it easy for people to lose coverage even when they meet the requirements or qualify for exemptions. In states that tried similar policies, most people who lost coverage were either already working or exempt – they were simply tripped up by confusing and burdensome reporting systems.
Those impacts wouldn’t fall evenly – working parents, caregivers, low-paid workers, and people with disabilities are among those most at risk. For families already balancing irregular hours, child care, and limited flexibility, a single missed notice or short reporting deadline could mean losing the coverage that keeps a child healthy or an adult able to work. And when parents lose coverage, their children are far more likely to become uninsured as well. These are the same Oklahomans who depend on consistent Medicaid access to manage chronic conditions, maintain employment, and keep their families stable – yet under H.R. 1, their coverage would be the first to go.
Losing coverage means losing medical care
Once people fall off Medicaid, many don’t find another source of insurance – they simply become uninsured. The result is predictable: skipped medications, delayed appointments, and preventable emergencies that drive up costs for everyone. Continuous coverage, on the other hand, improves outcomes and reduces churn.
The pandemic proved what stability can do. When states implemented continuous Medicaid coverage protections, families stayed insured, medical debt dropped, and children’s health outcomes improved. Research shows that maintaining continuous coverage saves states money and strengthens health and economic security. Our healthcare system should continue to prioritize prevention over costly last-minute healthcare.
When families lose coverage, communities pay the price
The damage doesn’t stop with the families who lose coverage. Hospitals and clinics – especially in rural and low-income areas – depend on Medicaid to keep their doors open. When Medicaid coverage declines, entire communities feel the effects: hospitals face financial strain (especially rural hospitals), providers reduce services, and access to care worsens for everyone, including those with private insurance.
H.R. 1 doesn’t strengthen Medicaid; it buries it under bureaucracy. Now that these new rules are law, states like Oklahoma face the fallout – more red tape, more families losing coverage, and a weaker health safety net for everyone. Every Oklahoman deserves a system that values care over paperwork – one where losing coverage isn’t as simple as missing the mail.
