OKLAHOMA CITY - Far right Republicans joined Democrats in the Senate to block plans to put major changes to Medicaid expansion on August's low voter turnout ballot.
The decision potentially sets the stage for two dueling legislative questions regarding the future of Oklahoma's Medicaid program to appear on November's general election ballot.
Voters could be asked to consider House Bill 4440, which seeks to remove Medicaid expansion from the Oklahoma Constitution and put it in state statute, allowing lawmakers to alter it.
They could also be asked to vote on House Joint Resolution 1067, which would allow lawmakers to end coverage for an estimated 200,000 lower-income Oklahomans if the federal match were to drop below the current 90% matching rate.
Senate President Pro Tem Lonnie Paxton, R-Tuttle, the author, said of the 41 states with Medicaid expansion, only three put it in their state constitution.
He said the measure does not repeal Medicaid expansion.
Voters narrowly approved a citizen-led state question in 2020 to expand Medicaid and enshrine it into the state Constitution. Lawmakers for years declined to expand Medicaid.
Supporters of removing the measure from the Constitution said it was necessary after the Oklahoman Health Care Authority, the state's Medicaid agency, said it needed nearly $500 million in additional dollars.
"Do you find it interesting that suddenly there was a huge increase in costs right before leadership began pushing a state question to end Medicaid expansion," asked Senate Minority Leader Julia Kirt, D-Oklahoma City.
Lawmakers began discussions about a Medicaid state question before the figures were released and the figures validated the need for it, Paxton said.
The measure would also allow lawmakers to impose work requirements on some recipients.
"The 90-year-old that's in a wheelchair that is blind gets treated exactly the same by Medicaid as the 25-year-old who is able bodied and can work and chooses not to," Paxton said. "This would allow that to come out of the Constitution and let us simply have the management authority over the way Medicaid would work in Oklahoma."
It passed by a vote of 30-8.
But it failed to secure the needed 32 votes to qualify for the Aug. 25 primary runoff ballot because members of the far right Freedom Caucus and Democrats didn't vote in favor of it.
Oklahoma's primary runoff elections typically have the lowest voter turnout rates.
Paxton asked for another vote on the Aug. 25 date, but that also failed to get the needed votes.
Without the votes, the measure would be on the Nov. 3 general election ballot, which has the highest voter turnout.
But the Senate also passed a second state question, House Joint Resolution 1067, that asks voters on Nov. 3 to repeal Medicaid expansion in its entirety if federal funding drops below 90%.
Senate Majority Floor Leader Julie Daniels, R-Bartlesville, said if both state questions pass in November, the measure removing Medicaid expansion from the Constitution would take effect "because that is the preferred option."
It would be highly unusual for lawmakers to put two state questions on the same topic on one ballot.
"It's clear you're rigging the rules when you have to run two bills to create two state questions on the same topic," Kirt said. "It's clear you don't trust voters if you're putting two measures forward to try to make sure you've covered all your angles."
Kirt called it a legislative "power grab."
Daniels said it was not a power grab, but an appeal to voters to help elected lawmakers manage the budget, which is a constitutional responsibility.
Both measures must return to the House for consideration.