Osiyo,
Oklahoma leaders often visit Cherokee Nation’s Health System and celebrate our progress and tout our unmistakable impact on the health and economy of rural communities.
Now, Governor Stitt is putting us on a path that will damage that very system.
Recently the Oklahoma legislature passed Oklahoma HB 4440 and HJR 1067 to reverse the will of Oklahoma voters’ 2020 expansion of Medicaid by putting it up for special votes in just a few short months. The same cabal of extremist lobbyists from out of state will flock to Oklahoma again in an attempt to reverse one of the most important health care initiatives in Oklahoma history.
None of those corporate and politically extreme interest groups care about the people I represent, or the more than 3 million patient services Cherokee Nation Health Services provides. They do not care whether you get healthcare. When Governor Stitt signs HB 4440 and HJR 1067, the crowning achievement of his two terms as governor, he will continue his campaign to rob tribal health systems blind and deny health coverage to over 250,000 Oklahomans.
I’m not going down without a fight. You shouldn’t either.
In 2020 Oklahoma voters approved Medicaid expansion and put it into the state’s constitution to keep it safe from Governor Stitt. This harnessed millions of new federal dollars annually, committed the state to pitch in, and led to health insurance coverage for hundreds of thousands of working Oklahomans, including Cherokee Nation citizens.
In 2025 Congress imposed new burdens on states that administer Medicaid expansion. Those burdens are a gut punch to rural states. Frankly, I am tired of Washington D.C. picking on rural America. But that is what happened. States like Oklahoma are feeling the pressure and are at a crossroads: Keep Medicaid expansion funded or retreat from what Oklahomans voted for. Retreat hurts Cherokee Nation, our patients and indeed the whole state.
The numbers tell the story. In 2025, Cherokee Nation Health Services supported nearly 17,000 Medicaid expansion patients, providing over 113,000 medical visits, 10,000 dental services, and 143,000 pharmacy services. This creates a $222 million economic impact annually, dollars that directly fund critical healthcare in rural and tribal communities, expand access to specialty care, and support local economies. Our Medicaid expansion spending alone creates or supports over 1,400 jobs across the region.
It is important to understand that tribal health systems do not cost the State of Oklahoma a nickel because Medicaid dollars are a “pass through” thanks to a 100% Federal match for Medicaid patients in Tribal health systems.
Removing or restricting Medicaid coverage would not just slow progress. It will immediately reduce healthcare access for almost 250,000 Oklahomans, not just Cherokees, but all tribal citizens and our neighbors. People will go without healthcare, suffer and many will die. It will jeopardize the sustainability of a system that has been carefully built and continually reinvested into by the Cherokee Nation.
Tribal health systems have expanded not because of increased federal spending (the feds provide pennies on the dollar of need), but because for decades tribes plowed every bit of third-party health insurance collections back into expanding and improving tribal health systems.
Cherokee Nation’s health system sets the standard across Indian Country. It is the system that boasts a billion dollars in modern facilities since Deputy Chief Bryan Warner and I took office, all without costing Oklahoma taxpayers a penny. It is the system that partners with Oklahoma State University to graduate new doctors and with the University of Oklahoma to graduate new nurses at a time when Oklahoma desperately needs both. It is a system that saves lives.
Cherokee Nation, and other tribes in Oklahoma, have made investments into healthcare based on Medicaid expansion. The effort to undo the will of Oklahoman voters jeopardizes these investments. Tribal healthcare does not cost Oklahoma. It saves Oklahoma money and saves Oklahomans lives. It improves access to healthcare and gives the state an economic boost.
If Governor Stitt succeeds in restricting or revoking Medicaid expansion, Cherokee Nation and other tribes will take a gut punch. Our progress in primary care, specialty care and wellness will be stalled. Even more rural hospitals will close. Everyone in Oklahoma, tribal citizens and our neighbors, will get less healthcare, resulting in more chronic disease and death.
Everyone pays hidden costs when people lose health insurance. Throwing people off health insurance gives them less access to basic healthcare but, when they inevitably get sick and receive uncompensated care, we all pay the price for their lack of coverage in the form of higher insurance rates and less productivity.
Governor Stitt opposed Medicaid expansion in 2020. He almost won. When he signs HB 4440 and HJR 1067, he will get a second chance and tribes will be his target.
Get informed. Get registered to vote – the deadline is May 22. Ask state leaders tough questions about Medicaid expansion, particularly those asking for your vote.
Wado,
Chuck Hoskin Jr.
Principal Chief
