Gov. Mary Fallin announced in November that Oklahoma would not expand its Medicaid program or create a state-based health care exchange.
Medicaid expansion and a health care exchange are two of the most debated elements of the Affordable Care Act, or Obamacare.
Were Oklahoma to expand its Medicaid program, an estimated additional 200,000 uninsured adults would qualify.
“Such an expansion would be unaffordable, costing the state of Oklahoma up to $475 million between now and 2020, with escalating annual expenses in subsequent years,” Fallin said in a statement in November. “It would also further Oklahoma's reliance on federal money that may or may not be available in the future, given the dire fiscal problems facing the federal government.”
Fallin is among about 15 Republican governors who have said their states will not expand Medicaid. Meanwhile, Republican governors in several states have voiced support for expanding Medicaid in some version in their states.
The Affordable Care Act originally mandated that, beginning in January 2014, states expand Medicaid to cover those people younger than 65 who also have an income below 133 percent of the federal poverty level.
But in June 2012, the U.S. Supreme Court struck down the part of the Affordable Care Act that penalized states for not expanding Medicare. This meant that states had a choice.
Currently, state Medicaid programs provide health coverage for lower-income people, families and children, some adults older than 65, and people with disabilities.
There are about 800,000 people enrolled in Oklahoma's Medicaid program, known as SoonerCare, according to the Oklahoma Health Care Authority. Of those enrolled, about 500,000 are children and 100,000 are dually eligible for Medicare and Medicaid.