In 2012, the United States Supreme Court ruled that the Medicaid expansion authorized by the Affordable Care Act 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. 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 their Medicaid programs to include the new group.

In a new report for the Oklahoma Hospital Association, Manatt Health examines the budget implications of using SoonerCare (Oklahoma’s Medicaid program) to cover this new adult group beginning in 2017. The report focuses on the five-year period between 2017-2021, during which new adult group costs and savings are expected to grow and then stabilize.