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ENGR. H. A. to ENGR. S. J. R. NO. 50 Page 1
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ENGROSSED HOUSE AMENDMENT
TO
ENGROSSED SENATE
JOINT RESOLLUTION NO. 50 By: Bergstrom of the Senate
and
Kendrix of the House
A Joint Resolution approving certain proposed
permanent rules of the Oklahoma Health Care
Authority; and directing distribution.
AUTHORS: Remove Representative Kendrix as principal House author
and substitute with Representative Eaves
Add the following House Coauthors: Kendrix and Hilbert
AMENDMENT NO. 1. Strike the title, enacting clause, and entire bill
and insert:
"A Joint Resolution directing the Secretary of State
to refer to the people for their approval or
rejection a proposed amendment to Section 2 of
Article XXV-A of the Constitution of the State of
Oklahoma; modifying duty of State of Oklahoma to
provide funding for certain persons pursuant to
federal Medicaid program based on modification of
certain matching amount of funding provided by the
federal government; providing for repeal of Sections
1, 2, 3, and 4 of Article XXV-A of the Constitution
based upon modification of federal funding provisions
in the Medicaid program; ordering a legislative
referendum; providing for enactment of statutory
provisions related to Medicaid funding based on
modification of certain matching amount of funding
provided by the federal government; prescribing
procedures for notification to the Secretary of
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State, the Governor, the Speaker of the Oklahoma
House of Representatives and the President Pro
Tempore of the Oklahoma State Senate; imposing duties
on the Attorney General for notification of events
related to modification of federal Medicaid funding;
providing ballot title; and directing filing.
BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES AND THE SENATE OF THE
2ND SESSION OF THE 60TH OKLAHOMA LEGISLATURE:
SECTION 1. The Secretary of State shall refer to the people for
their approval or rejection, as and in the manner provided by law,
the following proposed amendment to the Constitution of the State of
Oklahoma by repealing Sections 1, 2, as amended by Section 2 of this
measure, 3, and 4 of Article XXV-A of the Oklahoma Constitution.
The repeal of these sections shall only become effective as law if
the question contained in this measure is both approved by the
people and also if the federal government modifies the federal
medical assistance percentage (FMAP). If the federal medical
assistance percentage (FMAP) established under 42 U.S.C., Section
1396d(y) is modified, then within fifteen (15) days of the effective
date of such modification, the Attorney General shall send a
certification of that event to the Secretary of State, the Governor,
the Speaker of the Oklahoma House of Representatives, and the
President Pro Tempore of the Oklahoma State Senate. Each and every
one of those public officials, acting together or separately as
required, shall take such steps as necessary to cause the provisions
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of the Oklahoma Constitution to be modified in order to make the
repeal of Sections 1, 2, 3, and 4 of Article XXV-A of the Oklahoma
Constitution effective as law. Such actions shall be completed not
later than fifteen (15) days after the latest date upon which any
one of the public officials receive the certification required by
the provisions of this section.
SECTION 2. The Secretary of State shall refer to the people for
their approval or rejection, as and in the manner provided by law,
the following proposed amendment to Section 2 of Article XXV-A of
the Constitution of the State of Oklahoma to read as follows:
Section 2. A. In addition to those otherwise eligible for
medical assistance under Oklahoma's Medicaid program, the State
shall, until the conditions described in subsection B of this
section occur, provide medical assistance under Oklahoma's Medicaid
program to Low Income Adults and for medical services at health care
facilities for which the State receives a match of one hundred
percent (100%) pursuant to federal law.
B. No greater or additional burdens or restrictions on
eligibility or enrollment shall be imposed on persons eligible for
medical assistance pursuant to this Article than on any other
population eligible for medical assistance under Oklahoma's Medicaid
program If the federal medical assistance percentage (FMAP)
established under 42 U.S.C., Section 1396d(y) is reduced below
ninety percent (90%), then the constitutional duty imposed on the
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State by subsection A of this section shall cease to have effect,
notwithstanding any subsequent increases to such FMAP; provided,
however, this subsection shall not be construed to prohibit the
Legislature from enacting laws to provide Medicaid coverage to Low
Income Adults. The provisions of this subsection shall not be
applicable to medical services at health care facilities for which
the State receives a match of one hundred percent (100%) pursuant to
federal law.
SECTION 3. Pursuant to Section 3 of Article V of the Oklahoma
Constitution, there is hereby ordered the following legislative
referendum which shall be filed with the Secretary of State and
addressed to the Governor of the state, who shall submit the same to
the people for their approval or rejection. The enactment of
Sections 4, 5, and 6 of this measure shall only occur if this
measure is both approved by the people and also if the federal
government modifies the federal medical assistance percentage
(FMAP). If the federal medical assistance percentage (FMAP)
established under 42 U.S.C., Section 1396d(y) is modified, then
within fifteen (15) days of the effective date of such change, the
Attorney General shall send a certification of that event to the
Secretary of State, the Governor, the Speaker of the Oklahoma House
of Representatives, and the President Pro Tempore of the Oklahoma
State Senate. Each and every one of those public officials, acting
together or separately as required, shall take such steps as
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necessary to cause the statutory provisions contained in Sections 4,
5, and 6 of this measure to become effective as law and to cause
those provisions to become part of the Oklahoma Statutes in the same
manner as other enacted statutes. Such actions shall be completed
not later than fifteen (15) days after the latest date upon which
any one of the public officials receive the certification required
by the provisions of this section.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 7401 of Title 63, unless there
is created a duplication in numbering, reads as follows:
As used in this act:
1. "Centers for Medicare and Medicaid Services" or "CMS" refers
to the agency responsible for administering the Medicaid program at
the federal level, including review and approval of State Plan
Amendments;
2. "Low-income adults" refers to those individuals over age
eighteen (18) and under age sixty-five (65) whose income does not
exceed one hundred thirty-three percent (133%) of the federal
poverty level, as described by and using the income methodology
provided in the federal Medicaid statute at 42 U.S.C., Section
1396a(a)(10)(A)(i)(VIII), and who meet applicable nonfinancial
eligibility conditions for Medicaid under 42 CFR, Part 435, Subpart
E;
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3. "Medical assistance" means payment of part or all of the
cost of the care and services, or the care and services themselves,
or both, as provided in the federal Medicaid statute, 42 U.S.C.,
Section 1396 et seq.;
4. "Oklahoma Health Care Authority" refers to the single state
agency responsible for administering the Oklahoma Medicaid program
pursuant to 42 U.S.C., Section 1396a(a)(5); and
5. "State Plan Amendment" refers to the document(s) the state
submits to the Centers for Medicare and Medicaid Services for review
and approval before making a change to its program policies,
including setting forth the groups of individuals to be eligible for
medical assistance.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 7402 of Title 63, unless there
is created a duplication in numbering, reads as follows:
In addition to those otherwise eligible for medical assistance
under Oklahoma's Medicaid program, the state shall provide medical
assistance under Oklahoma's Medicaid program to low-income adults
and for medical services at health care facilities for which the
State receives a match of one hundred percent (100%) pursuant to
federal law.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 7403 of Title 63, unless there
is created a duplication in numbering, reads as follows:
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The Oklahoma Health Care Authority shall take all actions
necessary to maximize federal financial participation in funding
medical assistance pursuant to this act.
SECTION 7. The Ballot Title for the proposed Constitutional
amendment repealing Sections 1, 2, as amended by Section 2 of this
measure, 3, and 4 of Article XXV-A of the Oklahoma Constitution and
the enactment of statutory provisions related to Medicaid as set
forth in Sections 4 through 6 of this measure shall be in the
following form:
BALLOT TITLE
Legislative Referendum No. ____ State Question No. ____
THE GIST OF THE PROPOSITION IS AS FOLLOWS:
This measure proposes an amendment to the Oklahoma Constitution
by repealing Sections 1, 2, 3, and 4 of Article 25-A, and it
also proposes the enactment of substantially the same language
from those constitutional sections as statutes. The repeal of
the constitutional sections and the enactment of statutes to
replace those constitutional provisions would not occur unless
the federal government reduces the amount of money it pays to
states in order to operate the Medicaid program. It also
proposes an amendment to Section 2 of Article 25-A which relates
to Medicaid. This change in the Constitution would become
effective if this measure is approved by the voters. The change
is related to the amount of money the federal government
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provides for the Medicaid program. If the federal government
reduced the amount of money that it pays to states for the
Medicaid program to less than ninety percent (90%), then
Oklahoma would not be required to provide funding to pay medical
costs in the Medicaid program for certain low-income adults. If
this measure is approved and if the federal government modifies
the amount of money it pays to states for the Medicaid program,
then all of the provisions in the Oklahoma Constitution related
to Medicaid would be repealed, but the substantive language
related to Medicaid from the constitutional sections would
become enacted as statutes of the State of Oklahoma. The
statutes could be amended, repealed, or otherwise modified by
the Legislature pursuant to the same procedures that allow
enactment of laws during any regular or extraordinary session of
the Legislature. If the federal government makes funding
changes in the Medicaid program, the Attorney General would
notify several public officials and the officials would have
fifteen (15) days to update the text of the Constitution and
Oklahoma Statutes.
SHALL THE PROPOSAL BE APPROVED?
FOR THE PROPOSAL — YES _____________
AGAINST THE PROPOSAL — NO _____________
SECTION 8. The Chief Clerk of the House of Representatives,
immediately after the passage of this measure, shall prepare and
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file one copy thereof, including the Ballot Title set forth in
SECTION 7 hereof, with the Secretary of State and one copy with the
Attorney General."
Passed the House of Representatives the 7th day of May, 2026.
Presiding Officer of the House
of Representatives
Passed the Senate the ___ day of __________, 2026.
Presiding Officer of the Senate
ENGR. S. J. R. NO. 50 Page 1
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ENGROSSED SENATE
JOINT
RESOLUTION NO. 50 By: Bergstrom of the Senate
and
Kendrix of the House
A Joint Resolution approving certain proposed
permanent rules of the Oklahoma Health Care
Authority; and directing distribution.
WHEREAS, pursuant to Section 308 of Title 75 of the Oklahoma
Statutes, major rules shall be addressed in a joint resolution only
addressing major rules; and
WHEREAS, the proposed permanent rules in Oklahoma Health Care
Authority OAC 317:30-5-354, 317:30-5-355.2, 317:30-5-356, 317:30-5-
359.2, 317:30-5-659, 317:30-5-661.1, 317:30-5-661.5, 317:30-5-664.3,
and 317:30-5-664.5 meet the definition of major rule set forth in
Section 250.3 of Title 75 of the Oklahoma Statutes.
NOW, THEREFORE, BE IT RESOLVED BY THE SENATE AND THE HOUSE OF
REPRESENTATIVES OF THE 2ND SESSION OF THE 60TH OKLAHOMA LEGISLATURE:
SECTION 9. The following proposed permanent rules promulgated
by the Oklahoma Health Care Authority are hereby approved: OAC
317:30-5-354, 317:30-5-355.2, 317:30-5-356, 317:30-5-359.2, 317:30-
5-659, 317:30-5-661.1, 317:30-5-661.5, 317:30-5-664.3, and 317:30-5-
664.5.
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SECTION 10. The Secretary of State is directed to distribute
copies of this resolution to the Governor and the editor of “The
Oklahoma Register”.
Passed the Senate the 5th day of May, 2026.
Presiding Officer of the Senate
Passed the House of Representatives the ____ day of __________,
2026.
Presiding Officer of the House
of Representatives