SQ802: The Rundown

Updated: Jun 30, 2020

Welcome to The Rundown. This is our place and space within the Limitless Foundation to give you facts, figures, and fancy charts relating to healthcare as it currently exists in the United States. This part of our blog exists to inform the public and bring attention to initiatives, bills, laws, state questions, policies, petitions and much more in the great state of Oklahoma and beyond as we work to fulfill our mission statement and make healthcare accessible for all.

This part of our mission is incredibly timely as there is a State Question on Oklahoma’s Primary Election Ballot on June 30th, 2020 that directly affects healthcare accessibility across the state. Maybe you aren’t sure what a State Question is or why “SQ802” would make an impact on you, Limitless, or the state as a whole, but that is where we come in.

The following blog gives you a “fast fact” and in depth breakdown as well as some external reading sources to help you feel informed as you make your way to the polls to vote in this upcoming election.

55.5 percent of black people in comparison to 75.4 percent of white people used private health insurance.

12.1% of black people under age 65 do not have health insurance coverage.

43.9 percent of non-Hispanic black people in comparison to 33.7 percent of non-Hispanic white people rely on Medicaid or public health insurance.

These statistics showcase why it is important that we look to what is happening in healthcare today.

First, let's focus on the basics before we delve into all that is SQ802.

What is a State Question?

State Questions are measures to change Oklahoma laws or the state constitution that appear on the ballot for all voters. They can be added to the ballot by the Legislature or by an initiative petition from citizens. The upcoming State Question is through an initiative petition, brought up by citizens who went through a lengthy and arduous process of collecting signatures before the question made the ballot.

The State Question that is going to be on Tuesday’s ballot (referred to from now on as SQ802) was initiated and pushed by the group “YesOn802.” They gathered 313,677 signatures–the most in Oklahoma history–to put Medicaid expansion on the ballot. If you would like more information on how the movement came to be or what work went into making this question on the ballot possible, you can visit their page at https://yeson802.org/.

What exactly is SQ802?

SQ802 is working to expand Medicaid in the state of Oklahoma, and we are one of only 14 states that hasn’t adopted Medicaid Expansion.

This expansion would directly impact 200,000 Oklahomans who currently lack coverage, especially working Oklahomans since the maximum eligibility for a family of 3 is $9,564. The program would allow for increased screenings and prevention programs in addition to access to care. How? Medicaid expansion allows existing Medicaid programs in Oklahoma (currently known as “Soonercare”) to reach more people. Medicaid expansion would help Oklahomans struggling to get by, such as individuals making less than $17,000 a year or a family of three making less than $29,000.

How would it be funded?

Medicaid is a federally funded program that Oklahomans are already paying towards. With Medicaid expansion and the passage of SQ802, the federal government will pay 90 percent of the cost of the Medicaid expansion population in perpetuity, as specified in federal law. The state of Oklahoma will cover the remaining 10 percent; the Legislature will need to specify a funding source for the state share in the 2021 session; multiple funding options are on the table, including raising the Supplemental Hospital Offset Payment Program (SHOPP) fee on hospitals, earmarking a share of tobacco settlement revenues, and allocating general revenues.

Why is SQ802 important?

According to data by the Henry J Kaiser Foundation (featured above), 35% of Oklahomans are low income, yet only 18% of them are covered by Medicaid. This has led to a large uninsured population and many people not getting the medical care they need.

Over two million Americans with cancer rely on Medicaid programs for critical treatment and survivorship care. Furthermore, in the state of Oklahoma alone, 20,000 new patients will be diagnosed with cancer this year.

The cost of healthcare is rising, even more so for those with a new cancer diagnosis because of chemotherapy rounds, pharmaceutical products, and numerous hospital visits. According to a 2019 survey conducted by The Mesothelioma Center at Asbestos.com, 63% of cancer patients and loved ones reported financial struggles following a cancer diagnosis.

Without access to affordable treatment, cancer will continue to remain one of the leading causes of death, as people either

(1) find out their diagnoses later when their treatment options are extremely limited or

(2) cannot afford the treatment diagnosed by their doctors.

In fact, 20% of people have to pay over $20,000 out of pocket annually for cancer treatment. The disparity in the cost of treatment and the amount patients are willing to pay is immense, leading the estimate of expenditures for care to the uninsured from community health and other providers of direct care to $7.11 billion, thus increasing strains on clinics and treatment centers across the state and nation and the closings of rural hospitals across the country.

With the way COVID-19 has already overwhelmed a struggling system, these effects are expected to exponentially grow in the coming months. Because of the upsurges in the unemployment population, the uninsured population has also seen a similar uptick, as many Americans rely on employment to secure insurance benefits.

Being insured is directly correlated to lower healthcare outcomes and a greater probability of death, as uninsured adults are 25% more likely to die prematurely. Uninsured people are likely to only seek medical help when there is a medical emergency, meaning chronic conditions and illnesses such as cancer go undetected for much longer periods of time.

Access to healthcare and insurance is vital because many Americans live paycheck to paycheck and have very little if any money to spare for costly treatments. It starts with a bill that goes unpaid, then a treatment that gets delayed, until it severely limits their access to care; treatment options; and other vital screenings. Because of the combination of these factors, Oklahoma has one of the highest poverty and cancer death rates. At 15.8% under the federal poverty line and 177.3 deaths due to cancer per every 100,000 persons. Oklahoma needs to rethink its current strategy with Medicaid access, as many of these deaths can and should be prevented.

What will the ballot look like?

The wording of the ballot is as follows:

“Medicaid is a government-sponsored health insurance program for qualifying low-income persons. This measure would add a provision to the Oklahoma Constitution requiring the State to expand Medicaid coverage. The expanded coverage would include certain persons over 18 and under 65 who are not already covered and whose annual income, as calculated under federal law, is at or below 133 percent of the federal poverty line. The federal poverty line changes annually, but for example if this measure were in effect in 2019, the measure generally would have covered a single adult making less than $17,236 annually and adults in a family of four making less than $35,535 annually.

Under this measure the State cannot create additional restrictions that make it more difficult to qualify for expanded Medicaid coverage than it is to qualify for the Medicaid program currently in place.

The Medicaid program is funded jointly by the federal government and the State. This measure would require the Oklahoma Health Care Authority (OHCA) to try to maximize federal funding for Medicaid expansion in Oklahoma. If the measure is approved, OHCA has 90 days to submit all documents necessary to obtain federal approval for implementing Medicaid expansion by July 1, 2021.”


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