Oklahoma high court rejects challenge on Medicaid expansion

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OKLAHOMA CITY (AP) - Oklahoma's highest court on Tuesday rejected a legal effort to block a plan for a public vote on whether to expand Medicaid to tens of thousands of poor residents.

Just hours after hearing oral arguments in the case, the Oklahoma Supreme Court rejected the challenge spearheaded by a conservative think-tank that has long opposed to making the federally funded health insurance program available to more people.

The court's decision authorized supporters to proceed with gathering the nearly 178,000 signatures they will need to get the question on the ballot. The plan was challenged by the Oklahoma Council of Public Affairs, which argued that the proposed ballot language doesn't accurately describe what the measure does.

Here are some things to know about Medicaid expansion in Oklahoma:

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WHO'S ON EACH SIDE OF THE ISSUE?

Supporters of Medicaid expansion include doctors, hospitals, business and faith leaders and most Democrats in the Legislature, who say the expansion will infuse close to $1 billion in federal funding into the state's health care system each year, helping provide medical coverage to low-income Oklahomans who don't receive health insurance through work or who can't afford it.

Opponents, including Gov. Kevin Stitt and most Republicans, say the cost to the state, even with a 9-to-1 federal match, is a significant investment and raised concerns about what will happen if the state's share must increase in future years. Republican politicians in Oklahoma also have spent nearly a decade on the campaign stump demonizing the Affordable Care Act, former President Barack Obama's signature policy victory.

Travis Jett, the attorney for the Oklahoma Council of Public Affairs, on Tuesday urged justices to disqualify the proposal , saying it was inaccurate and could perpetrate deceit and fraud.

An attorney for supporters, Melanie Rughani, argued that the proposal meets the requirements of the state constitution and urged the court to allow it to proceed with gathering signatures.

In a two-page ruling, the court said the proposal "is not misleading and is sufficient."

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WHO'S UNINSURED IN OKLAHOMA?

More than 16% of Oklahoma's population was uninsured in 2017, giving the state the second-highest rate in the nation, behind only Texas, according to the most recent figures from Kaiser Family Foundation, a nonpartisan health policy research organization. Nationally, the uninsured rate is about 10%, about 7.6% in expansion states and 14.3% in non-expansion states.

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WHAT ABOUT MEDICAID IN OKLAHOMA?

About 786,000 Oklahomans, or 20 percent, currently are enrolled in Medicaid, and more than two-thirds of those enrolled in the program are children. Children in Oklahoma can qualify for Medicaid if the annual household income is about $35,500 per year for a family of two. Pregnant women also can qualify if their household income doesn't exceed about $22,500 for a family of two. Able-bodied adults without children do not qualify for Medicaid in Oklahoma, regardless of income.

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WHAT ABOUT MEDICAID EXPANSION?

So far 36 states and the District of Columbia have approved an expansion of Medicaid, while Oklahoma and 13 others have not. Under Medicaid expansion, health care would be available to those individuals making less than 133% of the federal poverty level, or about $16,000 annually for an individual or about $28,000 for a family of three. Estimates vary as to how many Oklahomans would qualify under Medicaid expansion, but a 2016 study commissioned by the Oklahoma Hospital Association projected about 272,000 Oklahomans would qualify in the first year.

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AP writer Tim Talley contributed to this report.

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