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SoonerCare is a lifeline Oklahoma can’t afford to lose
Oklahoma’s health care challenges don’t exist in a vacuum. They are the result of policy choices made by state and federal lawmakers — decisions that have consistently treated health care as something to cut back, rather than invest in. In the last five years alone, the majority of Oklahoma lawmakers have driven poorly targeted tax cuts that have reduced the state budget by more than $1.5 billion annually, choosing short-term political wins over investments in the health and well-being of Oklahomans. Meanwhile, Oklahoma’s Congressional delegation has repeatedly fallen short in its responsibility to protect and maintain federal health care funding. The result is a system less prepared to handle fiscal curveballs — leaving real people more vulnerable when those moments come. [Kati Malicoate / OK Policy]
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Policy Matters: Hard work should pay enough to live
At a recent League of Women Voters of Oklahoma forum, I spoke in support of State Question 832, which would gradually raise the minimum wage to $15 an hour and make sure it keeps up with rising costs. Opponents kept pointing to California as a cautionary tale. But if we’re looking for comparisons, there’s a more honest place to start: Oklahoma itself. [Shiloh Kantz / The Journal Record]
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Apply Now for the 2026 Oklahoma Summer Policy Institute
OK Policy’s Oklahoma Summer Policy Institute (SPI) brings together highly-qualified college students, recent graduates, and new policy professionals for a three-day learning experience that informs participants about Oklahoma’s policy landscape and provides tools and resources to create change in our state. Apply by 11:59 p.m., Sunday, May 10, 2026.
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Know someone who would be a good fit for SPI? Please send them the link above.
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"At the end of the day, families don’t live in rankings. They live in whether their child can read at grade level, whether they can see a doctor when they need one, whether help is there when someone is struggling, and whether they’re getting ahead or just getting by."
- Former Oklahoma Rep. Mark McBride, arguing that headline rankings and political talking points can distract from the realities families face day to day, and emphasizing that real progress should be judged by outcomes — not branding. [The Oklahoman]
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Legislative Referendum
A legislative referendum is the mechanism by which the Oklahoma Legislature can submit a constitutional amendment or statutory change to a vote of the people. A legislative referendum is one of two ways to place a State Question on the ballot in Oklahoma, the other being an initiative petition. A legislatively-initiated ballot measure must take the form of a Joint Resolution and be approved by a simple majority vote in both chambers. It does not require the Governor’s approval.
Once received by the Secretary of State, each legislative referendum is designated a State Question number and a Legislative Referendum number. Copies are delivered to the Governor and State Election Board to issue the Election Proclamation and place the measure on the ballot for a vote of the people at the time of the next general election. The Attorney General has the responsibility to review the measure’s ballot title and may rewrite the ballot title if s/he determines that the title proposed in the legislation does not meet requirements.
Between 1990 and 2024, there were 80 legislative referendums, of which all but seven were constitutional amendments. There were two legislative referendums on the ballot in 2020 but none in 2022 – the first time that voters have not been called on to decide a legislative referendum on a general election ballot since 1970. In 2024, voters split on two legislative referenda, rejecting SQ 833 that would have created public infrastructure districts, while approving SQ 834 that specified that only U.S. citizens are eligible to vote.
[Look up more key terms to understand Oklahoma politics and government here]
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Editorial, Enid News & Eagle: What's the plan to make up for lost revenue?
How about a plan in simple English that explains how the state makes up for lost revenue whenever a new tax cut is proposed? That shouldn’t be too much to ask.
Don’t get us wrong. We all enjoy a tax break. We all enjoy keeping more of our hard-earned money in our pockets. We also enjoy sound infrastructure, good schools, good roads and clean parks.
Property taxes pay for public schools, county administration and CareerTech.
Do any of the handful of proposals the state Legislature has approved or is considering approving state plainly how to make up any impending budget shortfalls?
A cut in property taxes definitely would be a welcome relief for homeowners, but what becomes of the community in which they reside?
Reported last week by Oklahoma Voice, as Rep. Andy Fugate, D-Oklahoma City, suggested it would have made a lot more sense to try and limit the runaway insurance premiums Oklahoma property owners are paying.
If we had manageable insurance like most states, property owners keep more of their money and schools and counties don’t have to deal with the lost revenue. Insurance companies that have been collecting huge profits from Oklahomans for years would instead bear the brunt.
We unfortunately don’t exist in an ideal world where we can cut our way to prosperity. Alternatives likely would be counties asking us to expand sales tax proposals and rural schools trying to push more and more bond issues.
It seems if there was a good plan to make up for lost revenue, those pitching the proposals would have led with it.
[Enid News & Eagle]
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$130 million - Medicaid and Medicare cuts from H.R. 1 (the One Big Beautiful Bill) are expected to create an annual net revenue loss of $130 million for INTEGRIS Health, one of Oklahoma’s biggest health care systems. The company confirmed Friday that it would be closing some clinics and reducing staffing at other locations during the next three to six months in order to accommodate those funding cuts. [INTEGRIS via Fox 25]
52% - In Oklahoma, Medicaid (SoonerCare) covered 52% of all births in 2024, making it the primary source of maternity care coverage in the state. Among other benefits, Oklahoma’s voter-approved Medicaid expansion allowed for greater access to preventive care before, during, and after pregnancy. [KFF]
86% - The share of nonworkers in the U.S. who are children, elderly, disabled, or students. Together, these groups make up the vast majority of people not in the workforce, while only about 2% fall into the unemployed or other categories. [People’s Policy Project]
2,343 - The number of children Oklahoma’s public pre-K programs declined by in a single year — dropping from the prior year to 36,114 enrolled in 2024–25. [The National Institute for Early Education Research]
43% - Two in 5 Medicaid enrollees (43%) in Oklahoma live in a rural area. [KFF]
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Hospitals brace for new wave of federal cuts as GOP turns to reconciliation again: The Trump administration’s fiscal year 2027 budget, released April 3, adds another accelerant: It proposes $15.8 billion in Health and Human Services cuts — a 12.5% reduction from 2026 — with significant cuts to the National Institutes of Health, among other healthcare programs. Hospitals are already staring down the barrel of up to $25 billion in annual revenue losses stemming from OBBBA Medicaid cuts. With another reconciliation bill taking shape, the next question on hospital leaders’ minds is how much deeper — and faster — this next round of health care cuts could hit. [Becker’s Hospital Review]
Medicaid Coverage Supports Rural Patients, Hospitals, and Communities: One in seven Americans live in rural areas and rely on rural hospitals and health systems for the health and well-being of their communities. Cuts to the Medicaid program, such as those enacted by Congress, will have a devastating impact on rural hospitals and patients. [American Hospital Association]
The Simple Math of Poverty: Poverty in wealthy societies stems fundamentally from four structural realities: income is distributed only to workers and capital owners; capital ownership is highly concentrated; a significant share of the population is not working at any time; and nonworkers are unevenly clustered across households. Together, these dynamics create predictable income gaps that persist across families. Addressing poverty effectively requires shifting how income is shared — such as through universal dividends or social wealth funds — and strengthening public income supports that reach nonworking groups like children, the elderly, students, and caregivers. [People’s Policy Project]
State Universal Pre-K Policies: Lessons from Florida, Oklahoma, and Vermont: High-quality universal pre-K programs have been shown to improve children’s academic outcomes, long-term earnings, and overall life outcomes, but access remains uneven across states and communities. Only a few states — like Oklahoma, Florida, and Vermont — have implemented truly universal programs, and their results vary widely depending on funding, quality standards, and program design. Programs with stronger teacher requirements, smaller class sizes, and more consistent standards tend to show more lasting benefits for students. Overall, expanding access alone isn’t enough — the quality and structure of pre-K programs play a major role in determining their impact. [Rockefeller Institute of Government]
The State of Rural Primary Care in the United States: Primary care is facing existential challenges — from lower relative investment compared to specialty care to clinician burnout — which are particularly acute in rural communities. Rural clinician shortages, limited broadband internet, and a lack of public transportation in rural areas make it difficult for patients to get health care, either in person or virtually. These access challenges are associated with poor health outcomes, low uptake of preventive services, and overreliance on costly emergency department visits for nonurgent health needs. [The Commonwealth Fund]
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What’s up this week at Oklahoma Policy Institute? The Weekly Wonk shares our most recent publications and other resources to help you stay informed about Oklahoma. Numbers of the Day and Policy Notes are from our daily news briefing, In The Know.
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