Medicaid; Oklahoma Health Care Authority; waiver; state plan amendment; expansion in cost-sharing; effective date.

HB 3599 requires Oklahoma's Medicaid program to implement a $35 copayment per service for Medicaid expansion enrollees (individuals covered under the expanded Medicaid program) starting November 1, 2026. The bill mandates this cost-sharing under federal guidelines, prohibits reducing copayments below $35 for nonemergency emergency department visits, and caps total annual cost-sharing at 5% of a family's quarterly income. It directs the Oklahoma Health Care Authority to file the necessary waiver or amendment by January 1, 2027, to enact these changes. This policy directly affects Medicaid expansion recipients by adding a new cost-sharing requirement for routine care.