OKLAHOMA CITY (April 8, 2026)—With the cost of Medicaid expansion exploding, lawmakers should send two state questions to voters that would allow for financial adjustment when needed, Oklahoma Council of Public Affairs (OCPA) President Jonathan Small said today.

“Medicaid expansion’s cost overruns came close to a half-billion dollars this year and could easily hit $1 billion per year in the near future, which will force massive cuts across the rest of state government and hold back progress and economic growth in Oklahoma,” Small said. “Given financial reality, Oklahomans should be given the opportunity to bring some stability to state government by passing state questions that reform this out-of-control system.”

House Bill 4440 would allow Oklahoma voters to remove Medicaid expansion from the state constitution and instead place expansion in state law, allowing lawmakers to amend the law as financial conditions require in future years.

House Joint Resolution 1067 would allow Oklahoma voters to amend the state constitution to repeal Medicaid expansion if the federal match is cut below the current 90-10 federal-state split for the expansion population of able-bodied adults.

Under the Medicaid expansion narrowly approved in 2020, able-bodied adults of working age were added to the welfare program.

“It does not make sense to financially penalize all Oklahomans to prop up a system that subsidizes 20-something males who are simply not working,” Small said. “Since Medicaid was expanded, we’ve seen no broad-based improvement in any meaningful health outcomes, only rising costs that threaten to punish working families. Oklahoma voters should be given the opportunity to reassess expansion.”