Estimated State Budget Impact of an Oklahoma SoonerCare Expansion

Estimated State Budget Impact of an Oklahoma SoonerCare Expansion -

In 2012, the United States Supreme Court ruled that the Medicaid expansion authorized by the Affordable Care Act (ACA) was optional. That is, each state could decide whether or not to use its Medicaid program to cover all adults with incomes below 138% of the Federal Poverty Level (FPL). States that opt to cover the new adult group receive an enhanced federal matching rate, starting at 100% in 2014 through 2016 and then declining annually and leveling off at 90% in 2020 and beyond. To date, 31 states plus the District of Columbia have expanded.

This report examines the budget implications of using SoonerCare (Oklahoma’s Medicaid program) to cover adults with incomes up to 138% of the FPL beginning in 2017. Were the State to take up this option, it is projected that 272,000 individuals would gain coverage in the new adult group on average during 2019 (the first calendar year of full enrollment after a ramp-up period). Prior to the application of any savings or revenue offsets, the fiveyear total costs associated with extending coverage to the new adult group are an estimated $8.3 billion, of which the federal government would finance $7.5 billion and Oklahoma would cover $739 million.