Health Care

Medicaid eating state budget, feeding national debt

November 19, 2018

Kaitlyn Finley

Note: This article was first published on Nov. 6, 2018. On Nov. 19, 2018, this article was republished to include federal dollars for SoonerCare’s total expenditures.

Total expenditures for Oklahoma’s Medicaid program (SoonerCare), as a percentage of total state spending, have nearly doubled over the past two decades.

In 1997, total spending for SoonerCare amounted to $1.91 billion (including state and federal dollars), or 16 percent of total state spending ($12.3 billion). 

Last year, total spending for SoonerCare was $5.49 billion, or 30 percent of total state spending ($18.2 billion).

Total Oklahoma Medicaid Spending as a Percentage of Total State Spending


Oklahoma’s share of Medicaid costs has grown from $536 million to $2.3 billion, more than a 329 percent change since fiscal year 1997.

Appropriated dollars for SoonerCare, as a percentage of all state appropriations, have doubled over the past twenty years.

In 2017, the Oklahoma Legislature appropriated a total of $6.88 billion. The Oklahoma Health Care Authority (OHCA), which administers SoonerCare, received $1.029 billion, or 15 percent of those appropriated dollars. That's compared to the $460 million, or 7 percent of all appropriated dollars, OHCA received in 1997.



Medicaid has continued to take a large chunk out of the federal budget as well. The Congressional Budget Office Historical Budget Data from April 2018 recorded the annual federal costs for Medicaid increased from $151 billion to nearly $389 billion from 1997 to 2017, and Medicaid expenditures as a percentage of all federal spending increased from nearly 6 percent to 9.4 percent respectively.

Rising Medicaid costs add to the growing federal deficit. The Congressional Budget Office estimated the federal deficit for fiscal year 2018 was $758 billion. Although most state governments cannot constitutionally run a deficit in their budgets, they have no problem relying on borrowed federal dollars to fund their welfare programs.


This article is part of a series on Oklahoma's Medicaid program, SoonerCare. Other articles in the series include:
What is Medicaid?
Charting Oklahoma Medicaid Growth over the past 20 years


Note: All dollar figures in this article have been adjusted for inflation using 2018 dollars.