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Two hold-out states, Missouri and Oklahoma, expand Medicaid in 2021

Missouri and Oklahoma, which had previously been 2 of the 14 states to withhold Medicaid expansion, approved the measure in 2021. Voters in both states voted to approve Medicaid expansion and the states began taking applications during the summer of 2021. 


The expansion made approximately 190,000 Oklahomians and 275,000 Missourians eligible for Medicaid. Already, 120,000 people in Oklahoma have applied for and were determined eligible to receive coverage since July 2021. Missouri has processed 17,000 applications since August 2021. 

The American Rescue Plan is helping states foot the bill for Medicaid expansion. Oklahoma is expected to receive $500 million and Missouri is expected to receive $968 million to support Medicaid expansion over the next two years. States that expand Medicaid also qualify for 90% federal matching funds currently available through the ACA for Medicaid expansion enrollees. 

Doctor in lab

"Medicaid is a lifeline for millions of people in this country and a step in the long road to achieving health equity by providing access to essential health care," said CMS Administrator Chiquita Brooks-LaSure about the expansion. 

Other states that still have not expanded include: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming.

Leadership and advocacy organizations in these states are strongly pushing for Medicaid expansion. Fair Fight, Stacey Abrams’ organization in Georgia, is one of those organizations which just launched a new Medicaid expansion campaign last week. 


This week, Fair Fight followed with an even bigger announcement–it bought $212 million in medical debt to forgive the debts of 108,000 families across the South. They say this is a first step to relieving medical debt. The next step is Medicaid expansion. 

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