Health Care

Oklahoma death rate increases after Medicaid expansion

July 30, 2026

Ray Carter

When voters narrowly approved a ballot measure to expand the Medicaid program to include many able-bodied adults, supporters vowed the billions of dollars in increased taxpayer spending would improve health outcomes in Oklahoma.

But data continue to show otherwise. The latest example is a report showing the death rate in Oklahoma was higher in 2025, after years of Medicaid expansion, than it was in 2015, before Medicaid expansion.

A recent Stateline analysis of provisional Centers for Disease Control and Prevention data showed that the age-adjusted death rate in Oklahoma increased from 904.3 deaths per 100,000 population in 2015 to 948.3 deaths per 100,000 population in 2025.

The death rate in Oklahoma in 2025 exceeded the death rate in most states that have not expanded Medicaid—at times by significant and even dramatic margins.

One expert says that should not surprise anyone.

“The data shows that, once again, the false promises of Medicaid expansion never materialized,” said Hayden Dublois, data and analytics director for the Foundation for Government Accountability. “Oklahomans were led down a misleading path by the radical activists pushing the Medicaid expansion ballot measure. Now, the chickens have come home to roost. Oklahoma is diverting scarce taxpayer resources to cover well over 200,000 able-bodied expansion adults under ObamaCare, all without measurable improvement in key health indicators, like the state’s death rate. Now more than ever, Oklahoma policymakers should work to preserve resources for the truly needy and combat waste, fraud, and abuse—because Medicaid expansion simply hasn’t worked.”

The death rate in neighboring Texas, which has not expanded Medicaid, was virtually unchanged since 2015 and was notably lower than the rate in Oklahoma. The death rate in Oklahoma was 27 percent higher than in Texas, according to federal data.

Neighboring Kansas, which has also declined to expand Medicaid, also has a much lower death rate. The death rate in Oklahoma was nearly 21 percent higher than the rate in Kansas in 2025.

The states that have not expanded Medicaid include Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. Nine of those 10 states have lower death rates than Oklahoma, despite Oklahoma having expanded Medicaid for more than five years now with billions cumulatively expended over that time.

Most notably, the death rate in Oklahoma is 49 percent higher than the rate in non-Medicaid-expansion Florida.

Among the states that border Oklahoma, four of six have also expanded Medicaid: Arkansas, Colorado, Missouri, and New Mexico. All four had a higher death rate in 2025 than in 2015. In New Mexico, the death rate surged 9.1 percent from 2015 to 2025 while having Medicaid expansion in place throughout that entire decade.

Due in part to Medicaid expansion, the Oklahoma Health Care Authority, which administers the program, requested a budget increase of nearly half a billion dollars at the start of the 2026 legislative session, a sum that threatened to rapidly deplete Oklahoma’s record savings if no changes are made.

Because of the dramatically rising costs of Medicaid and the lack of any significant improvement in health outcomes, lawmakers debated measures during the 2026 legislative session that would have allowed voters to remove Medicaid expansion from the Oklahoma Constitution and allowed the state to impose work requirements before able-bodied adults can qualify for Medicaid.