Medicaid expansion is working just as expected

Oklahoma has successfully expanded Medicaid, as more than 210,000 Oklahomans have enrolled in expansion and there have been substantial declines in the uninsured rate across all demographics. Though it is too soon to definitively identify the long-term benefits for the state and the newly enrolled, it’s safe to say that Medicaid expansion has done what it was expected to: provide thousands of our friends and neighbors with peace of mind about their health. As many as 144,000 previously uninsured Oklahomans can finally see a doctor and fill a prescription, and thousands more have access to more comprehensive, affordable insurance than they had before the state expanded.    

Medicaid expansion provides more comprehensive, affordable coverage for many Oklahomans   

The goal behind the Medicaid program — including expanding coverage to low-income residents — is to provide accessible health care for people who need it. Due to improved coverage and lower costs, some Oklahomans will move from other insurance plans to Medicaid. This move benefits both the enrollees and the state, as access to more comprehensive and affordable care leads to a more productive, reliable, and healthy workforce for our state. 


About 68,000 Oklahomans became eligible for expansion benefits because the Oklahoma Health Care Authority (OHCA) reprocessed their applications to check for expansion eligibility. Of those, somewhere between 23,000 and 38,000 were previously eligible for Insure Oklahoma, the program that allows individuals to purchase health care from the state. For qualifying individuals, the transition to Medicaid coverage will mean access to a health plan without paying monthly premiums. For people making less than 138% of the federal poverty line ($1,483 per month for one person), Insure Oklahoma premiums made it unaffordable for some low-income workers. Providing more affordable coverage through Medicaid expansion will likely make accessing health care more feasible for many people. As thousands move from Insure Oklahoma to Medicaid expansion, the transition will save the state money through a higher federal matching rate.  

Similarly, about 51,000 of the 171,000 Oklahomans who currently access health care through the federal Marketplace will likely qualify for Medicaid coverage. As Marketplace enrollees reapply for coverage for the 2022 calendar year, Medicaid-eligible individuals will be identified and their information will be sent to the Oklahoma Health Care Authority. OHCA can further ensure access to health coverage by following up with these eligible individuals and equipping community enrollment partners with information to do the same.  For Medicaid-eligible individuals, Medicaid coverage will provide more affordable insurance than the Marketplace, as enrollees will no longer be subject to monthly premiums. 

Additionally, a small number of Oklahomans may shift from private, employer-sponsored health insurance to Medicaid. Though studies have found that Medicaid expansion increases overall coverage rates but doesn’t have a significant impact on rates of employer-sponsored insurance, there will likely be some who make this shift, and they will likely be better off because of it. In some cases, a worker may be unable to afford to purchase employer-sponsored coverage at full premium for their spouse or all dependents because the employer does not contribute to paying those premiums. Medicaid expansion allows that entire family to access coverage, keeping everyone healthy, at work, and at school. Some low-income employees might turn to Medicaid as a supplement to employer coverage. Finally, for many workers, expansion represents the first opportunity to access coverage in years, because employer-sponsored coverage was either unavailable or too expensive. Regardless, the impacted individuals will gain access to more affordable and comprehensive care, which will in turn make them better and more productive workers

Medicaid expansion provides vital access for patients and stabilized health care providers  

About 40 percent of expansion enrollees have accessed some type of health care after enrolling in Medicaid expansion, according to the OHCA on Aug. 26, 2021. If the rate is similar today, about 80,000 Oklahomans have accessed care. In a recent legislative update, OHCA CEO Kevin Corbett told a story of a 62-year-old woman who hasn’t seen a primary care physician or a dentist in 20 years, and who now has both appointments scheduled because of expansion’s “truly life-changing” impacts. While long-term data is not yet available for comparison, early data suggests that Oklahomans enrolled through Medicaid expansion are proactively seeking medical services rather than relying on emergency rooms for health care options. We will continue to monitor this trend moving forward. 

This relatively low utilization rate by expansion enrollees could be a result of confusion among new enrollees about what services are available and how to access them. Regardless of current rates, expansion is making our hospitals across the state more financially stable by protecting them from uncompensated care. Louisiana hospitals saw a 33 percent decrease in uncompensated care after expansion, with particular benefits for rural hospitals. When the more than 210,000 Oklahomans enrolled in expansion coverage seek necessary care in the future, hospitals and providers will be more likely to receive reimbursement for that care.

Medicaid expansion has brought good and necessary change to Oklahoma 

As a result of voters’ decision to expand Medicaid, significantly more Oklahomans have new or improved access to life-changing health insurance. As a result, our friends and neighbors will have greater access to care and improved health outcomes, employers statewide can count on a healthier workforce, and health care providers — especially in rural areas — can strengthen health care delivery in their communities. In just a short time, we’ve already seen Medicaid expansion make a difference in the lives of Oklahomans, and the investment Oklahoma is making in healthy residents should be paying off for years to come. 


Additional resources: 


Emma Morris worked as Oklahoma Policy Institute's Health Care and Fiscal Policy Analyst from April 2021 to January 2024. She had previously worked as an OK Policy intern and as the Health Care Policy Fellow. Previous experience included working as a case manager with justice-involved individuals and volunteering as a mentor for youth in her community. Emma holds dual bachelor’s degrees in Women’s and Gender Studies and Public and Nonprofit Administration from the University of Oklahoma, and is currently working on a Master of Public Administration degree from OU-Tulsa. She is an alumna of OK Policy’s 2019 Summer Policy Institute and The Mine, a social entrepreneurship fellowship.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.