Oklahoma, OK.

By a pencil-thin margin, voters in the deeply conservative, Republican-led Sooner State chose on Tuesday to expand Medicaid benefits to low-income residents.

Oklahoma’s governor and legislature opposed the action, so voters had to override them by adding Medicaid expansion to the state constitution, effective on July 1 of next year.

With all precincts reporting in Tuesday’s vote, the Medicaid measure — State Question 802 — passed by fewer than 6,500 votes, reports The Oklahoman newspaper in Oklahoma City. That amounts to just 50.5% of the vote.

“In the middle of a pandemic, Oklahomans stepped up and delivered life-saving care for nearly 200,000 of our neighbors, took action to keep our rural hospitals open, and brought our tax dollars home to protect jobs and boost our local economy,” Amber England, a leader of the advocacy group Yes on 802, told the newspaper.

England said the expansion is expected to bring more than $1 billion a year in additional federal funds to Oklahoma; the state must pick up 10% of the total cost.

Great news out of Oklahoma as voters insist on Medicaid expansion. It’s proof that Americans are often ahead of their elected politicians, and that even in very conservative areas, real progress is possible on life-and-death issues like health care.https://t.co/7xbOjQXchA

— Pete Buttigieg (@PeteButtigieg) July 1, 2020

Gov. Kevin Stitt fiercely opposed the Medicaid question because, he said, it would require either spending cuts for education, public safety and infrastructure, or raising taxes — which he flatly refused to do.

England pointed out that earlier this year Stitt vetoed an agreement that would have funded the expansion without tax increases or spending cuts.

“The campaign for SQ 802 was launched after years of legislative inaction on Medicaid expansion,” reports The Oklahoman. “The Yes on 802 campaign turned in a record number of signatures to qualify the question for the ballot.”

Some comments on Twitter tied the results of the vote to President Trump, who wants to dismantle the Affordable Care Act (Obamacare) and who drew a paltry crowd to a campaign rally in Tulsa on June 20.

June 20: Trump rally in Tulsa, OK

June 30: Oklahoma voters vote to expand Medicaid under Obamacare, "effectively preventing Oklahoma’s GOP-controlled Legislature and Republican governor from limiting or undoing the expansion." https://t.co/IQQMNnttW7

— Mike Memoli (@mikememoli) July 1, 2020

Despite the statewide victory, most of Oklahoma’s 77 counties rejected the expansion. Just seven approved the question, though they included the state’s two biggest urban areas, Oklahoma County (much of Oklahoma City) and Tulsa County.

“Oklahoma has the second highest uninsured rate in the nation, behind only Texas,” reports CNN on MSN. “Some 14.2% of Sooner State residents lacked coverage in 2018, according to the latest Census Bureau data available.”

With Oklahoma, 36 states and the District of Columbia have now expanded Medicaid, including five led by Republicans. Missouri voters will consider the question in August.