Oklahoma Faces New Medicaid Work Rules and Added Costs

Thousands of residents will need to meet new requirements

Oklahoma’s new Medicaid work requirements could impact tens of thousands of residents and cost millions to manage, according to the Oklahoma Health Care Authority (OHCA).

The change is part of the Big Beautiful Bill, which adds work mandates for certain Medicaid recipients. Lawmakers designed the plan to encourage employment and reduce long-term dependency on public assistance.

Who the new Medicaid rules affect

Under the new rules, able-bodied adults must prove they are either working, attending school, volunteering, or participating in job training programs to maintain Medicaid coverage.

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Christina Foss, Chief of Staff for the OHCA, told legislators that the agency is preparing new technology systems to track compliance.

“Our goal is to help members succeed while meeting federal requirements,” Foss said. “We will make sure support and education are available to help people stay covered.”

The cost of compliance

The new reporting system will cost an estimated $5.1 million. That includes upgraded software, expanded data systems, and contract staff to verify work activities.

OHCA officials say the investment is necessary to avoid federal penalties. But critics argue the cost outweighs the benefits, especially for low-income Oklahomans who could lose coverage if they fail to meet the new rules.

Broader impact

Health advocates warn that tracking compliance could create bureaucratic hurdles for working parents, part-time employees, and students. Lawmakers insist the change promotes self-sufficiency and workforce participation.

Foss said the agency will release guidance before the rules take effect next year. Training for staff and partners will begin in early 2026 to ensure smooth implementation.

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