Rural Health Policy Project

Medicaid Waiver Proposal For Oklahoma Medicaid Beneficiaries Would Harm Low-Income Families With Children


Through an amendment to its Section 1115 Medicaid demonstration waiver, Oklahoma is seeking federal permission to impose work reporting rules on very low-income parents and caregivers age 19-50 receiving health coverage through Medicaid. Parents of children below age six would be exempt. Under the proposal, which would be phased in, these beneficiaries would have to document that they are working at least 20 hours a week or participating in job-training or volunteer activities or lose their SoonerCare coverage. Because Oklahoma has not expanded Medicaid under the Affordable Care Act, the only adults affected are parents whose incomes are at or below 45 percent of the federal poverty level, which is the equivalent of $779 per month for a family of three.

An estimated 4,000 to 13,000 of Oklahoma’s poorest parents could lose health coverage if the federal government approves the state’s request to impose new work reporting rules on parents and caregivers receiving Medicaid. The coverage losses would predominately affect Oklahoma’s poorest mothers. The impact would likely hit hardest in the state’s small towns and rural communities, where families are more likely to be insured through Medicaid and where jobs are harder to find.

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Joan Alker is the Executive Director of the Center for Children and Families and a Research Professor at the Georgetown McCourt School of Public Policy.