Day 47- Medicaid at 50: State Highlight: Oklahoma

Over the coming weeks this blog will highlight a key feature of Medicaid and the individual states that administer Medicaid leading up the the program’s 50th anniversary (July 30th). Hopefully, you’ll learn some interesting facts about Medicaid and each of the 51 state programs

Basics: Oklahoma covers 808,000 people in its Medicaid program, SoonerCare.

Section 1902(a)(73) of the Social Security Act requires state Medicaid agencies to establish a regular, ongoing process for seeking advice from tribal programs in their state (including the Indian Health Service and others). This is an important process in Oklahoma, which at 471,738 has the highest Native American population of any state (for some perspective, California is #2 at 381,274). The Oklahoma Health Care Authority must have government-to-government consultation with tribal nations on CHIP and Medicaid related matters – including waivers, waiver extensions, State Plan Amendments, and demonstration projects – prior to submitting proposals to CMS. As dual citizens, Native Americans can be eligible for Medicaid as well as IHS and other tribal health services. (Oklahoma has 638 tribal health care facilities.)

The Oklahoma Department of Human Services has a fascinating origin story that begins with the Dust Bowl (I recommend the Department’s 75th anniversary video). A highlight of the story is that apparently a lot of the original Medicaid legislation was drafted in Oklahoma.


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