Medicaid is a public insurance program that provides health coverage to low-income families and individuals, including children, parents, pregnant women, seniors, and people with disabilities. The program, which was created by Congress in 1965 as Title XIX of the Social Security Act, is operated by the states and funded jointly by the federal government and the states.

In Oklahoma, the Medicaid program is known as SoonerCare and is operated primarily by the Oklahoma Health Care Authority. In FY 2020 (prior to Medicaid expansion), the Medicaid program served just over 1 million individuals at some point over the course of the year, a figure that had remained largely unchanged since FY 2012. As of November 2021, SoonerCare’s total monthly enrollment was 1,135,844 people. Of these, well over half (58 percent) were low-income children 18 years and under.

Oklahoma’s total Medicaid spending was $5.686 billion in FY 2020, with the federal government accounting for $3.644 billion of that amount. The federal matching rate (FMAP) for most expenses was 66.0 percent in FY 2020.