This legislative session, Oklahoma lawmakers will consider hundreds of health bills on various topics, including Medicaid, maternal health and medical freedom.
The One Big Beautiful Bill Act
Several bills address President Donald Trump’s megabill and its policy impacts on Medicaid. SB 1547 by Sen. Christi Gillespie, R-Broken Arrow, conditions Medicaid eligibility for adults ages 19 to 64 on fulfilling work requirements of 80 hours per month, effective Jan. 1, 2027. Exceptions exist for specific populations.
HB 3599 by Rep. Mark Lepak, R-Claremore, requires the Oklahoma Health Care Authority to file a Medicaid waiver or state plan amendment on or before January 2027 to impose a $35 cost-sharing requirement per provision of care, items or services for expansion enrollees.
HB 3602, also by Lepak, addresses changes to provider taxes, which help finance states’ share of Medicaid spending.
HB 3975 by Rep. Trey Caldwell, R-Faxon, covers the Rural Health Transformation Program – a $50 billion fund signed into law alongside billions of dollars in reductions to federal Medicaid spending. Oklahoma received over $223 million for its first program year.
Caldwell’s legislation aims to ensure oversight of federal funds received by the State Department of Health, which serves as the lead agency for Oklahoma’s participation in the program.
Maternal and reproductive health care
Dozens of policies on maternal and reproductive health care will be up for consideration this session.
SB 1503 by Sen. Julie Daniels, R-Bartlesville, would allow out-of-state organizations to be reimbursed under Choosing Childbirth. The program has supported pregnancy resource centers and other nonprofits, becoming a key part of Oklahoma’s strategy to assist young children and pregnant women after the state enacted a near-total abortion ban in 2022.
SB 1657, HB 2945 and SB 2054 target the distribution of abortion-inducing drugs. Similar policies have advanced in past years but haven’t reached the governor’s desk.
HB 2948 by Rep Jim Olsen, R-Roland, covers what is defined as “assisted reproductive technology,” which concerns things like IVF, artificial insemination and egg, sperm or embryo donation.
It requires the State Department of Health to have fertility clinics track and report on data points, including how many embryos each fertility clinic creates, what happens to the embryos, how many embryos are frozen and how many pregnancies and live births result from “assisted reproductive technology procedures.”
The department will be required to publish a report on this data.
Sen. Nikki Nice, D-Oklahoma City, is again seeking to support access to free menstrual products in each school district and public charter school. SB 1353 would create a revolving fund for the State Department of Education to accomplish that.
SB 1431 by Sen. Jo Anna Dossett, D-Tulsa, would allow pharmacists to dispense self-administered contraceptives to patients without a prescription. This is another effort by Dossett to address contraceptive access, after lawmakers passed her legislation that reduced the number of trips women have to make to the pharmacy.
A few policies – including HB 3904, SB 1648 and SB 1329 – seek Medicaid reimbursement for depression screenings during pregnancy and postpartum. According to the CDC, maternal mental health conditions are a leading cause of pregnancy-related death.
Medical freedom
HB 4124 and SB 1907, by Rep. Scott Fetgatter, R-Okmulgee, and Sen. Shane Jett, R-Shawnee, respectively, would allow pharmacists to dispense ivermectin without a prescription. SB 2014, by Sen. Casey Murdock, R-Felt, would allow it to be sold or purchased over the counter.
Ivermectin is used to treat conditions in animals, like heartworms and other parasites, and in humans, including some parasitic worms and external parasites like lice. It was supported by some groups as a treatment for COVID-19. But the FDA determined available clinical trial data do not demonstrate effectiveness against COVID-19 in humans.
Jett and Rep. Kevin West, R-Moore, are seeking to allow health care providers to object to providing medical procedures or services that conflict with their conscience through SB 1798 and HB 3136. West, who has backed legislation on the topic in previous years, held an interim study on the matter in October.
Miscellaneous measures
Health care sharing ministries are proving to be popular, with at least five bills filed on the topic, including SB 1402, SB 1279, SB 2158, SB 1406 and HB 2942.
The legislation essentially seeks to allow tax deductions from Oklahoma adjusted gross income for the amount paid by an individual for membership in the ministry and exempt from their taxable income the amount they receive as a result of their membership to assist with a medical expense. This would apply during 2027 and subsequent tax years.
These ministries, according to healthinsurance.org, are non-insurance entities where members share a common set of ethical or religious beliefs, and expenses in accordance with those beliefs. The monthly amount members pay is typically far less than full-price premiums for individual major medical coverage. But the nonprofits are not regulated by state insurance commissioners or the Affordable Care Act.
Several bills – one of which was authored by Senate Health and Human Services Committee Chair Paul Rosino, R-Oklahoma City – address sudden and unexpected deaths of infants and children in five different cases, including sudden arrhythmic death syndrome and sudden infant death syndrome.
Medical examiners would have to conduct an investigation not more than 48 hours after a death has occurred. They would be required to include an autopsy if deemed necessary, microscopic and toxicology studies, and a review of the infant or child’s immunization and medical records.
The examiner would document in their report any immunizations or emergency countermeasures administered to the infant or child within 90 days before their death and report the case to a national surveillance system coordinated by the CDC and NIH.
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