Health Care, Law & Principles

The ‘One Big Beautiful Bill’ resolves questions favorably over work requirements

July 9, 2025

Ryan Haynie

In 2019, Governor Kevin Stitt gave an interview in which he dubbed SQ 802 (Medicaid Expansion) “Plan F.” In the interview, he correctly noted that “when [Medicaid expansion is] part of our constitution, that puts handcuffs on us and how we deliver services.” From the standpoint of state lawmakers, once something is in the state constitution, the only way to amend it is through the cumbersome amendment process. Well, almost. 

One reform many people have asked for in the past is work requirements for Medicaid expansion recipients. In fact, it was one of the things Stitt mentioned in the 2019 interview that he would like to see in any expansion efforts. There exists a difference of opinion about whether the Oklahoma Constitution prohibits work requirements for expansion recipients. 

The “One Big Beautiful Bill” (OBBB) moots the issue. Regardless of what limitations may be placed on Medicaid expansion eligibility by the Oklahoma Constitution, they’re superseded by federal law. The OBBB requires states with an expansion population to make productivity—via work, training, or volunteering—a condition to receive Medicaid benefits. It’s a rare, common-sense win from Congress. 

Even without constitutional constraints, states like Arkansas have found it very difficult to implement work requirements on their own, despite the success of that reform while it lasted. Anytime you have a bill as large as the OBBB, there are sure to be some problematic policies. But requiring able-bodied individuals to be productive in order to receive welfare is not one of them. Oklahoma’s congressional delegation deserves kudos for this one!