ABSTRACT
This chapter aims to identify historical, cultural and political variables which led the state to pursue an incremental approach over universal reform. Political factors can play a major role in health care implementation. Generally regarded as a conservative state, Oklahoma is among a number of southern states which have seen rapid growth of the Republican Party after years of domination by Democrats. Oklahoma had begun to experience trouble in the management of Medicaid even in the 1970s, but the huge cost increases were not seriously addressed until the 1990s. Medical Savings Accounts have been implemented in a number of states, but hard data is being gathered. Oklahoma’s reform effort suffered a severe financial setback when State Question 647, the health provider tax, was defeated by voters in 1992. Oklahoma’s commitment to incremental implementation of health reforms is also apparent in SoonerCare, the state’s effort to introduce managed care into the Medicaid program.
