The citizens who organized, advocated, and voted for Medicaid expansion in Oklahoma saw a major milestone achieved on July 1 when the new law that was placed into the constitution by voters last year went into effect. Now anyone aged 19-64, previously ineligible for health care coverage under Medicaid, can sign up and receive benefits if they do not exceed the income and asset limits. The Oklahoma Health Care Authority has estimated more than 200,000 people previously ineligible will now qualify. To its credit, the legislature approved a budget of $164 million in funding for the expansion. Ninety percent of the cost is paid for by the federal government.
Probably the biggest winners will be substance abuse and serious mental illness prevention and treatment services for adults. In the past, these services were ineligible for Medicaid payment. State funding provided some services through the Department of Mental Health and Substance Abuse Services, but the programs were chronically underfunded leaving many untreated with long waits for services. By the time services were available, it was often too late. If there is anyone who is likely to be in an income category below the Medicaid limits, it is a person suffering from debilitating addiction or mental illness. Thanks to the Affordable Care Act and Medicaid expansion, those people will now have a chance to regain their health.
I was surprised to see how low the income threshold is for coverage. To qualify, a person must have an estimated annual income of less than $17,796 for an individual or $36,588 for a family of four. Doing the math on a single individual, that’s $342 per week or $8.56 per hour for a worker, and roughly double for the family of four. There are plenty of people earning more than that who will still be unable to buy insurance, but expansion will provide coverage for the poorest of the poor, finally.
Those who worked hard to make Medicaid expansion happen through the ballot box deserve to feel good about it. But they can’t rest on their laurels for too long. There’s plenty more to do in Oklahoma, and voters seem willing to listen to good ideas.