Oklahoma lawmakers have filed dozens of bills this year to expand access to health care and social services and improve child welfare policies after enacting one of the strictest abortion bans in the country.

Legislators, experts and advocates have been pushing for improvements in Oklahoma’s poor outcomes for kids and families for several years, said Gabrielle Jacobi, a policy analyst with the left-leaning Oklahoma Policy Institute. But the state’s Republican-controlled Legislature has not historically approved or funded many of these policies. Lawmakers say they expect that to change, though, now that all abortions are banned in the state. 

The Dobbs V. Jackson Women’s Health Organization U.S. Supreme Court ruling last year, which allowed states to once again outlaw abortion, has motivated state lawmakers to take a closer look at support services for families, said Rep. Mark Lawson, R-Sapulpa, who chairs the House appropriations subcommittee on human services.

“Once children are born, are we doing the absolute best we can do by children and their families?” Lawson said. 

Many of the bills pull directly from recommendations from Gov. Kevin Stitt’s HELP Task Force. Stitt created the task force to study how to support women through unplanned pregnancies after he signed Oklahoma’s near-total ban on abortion in 2022. He also created a child welfare task force to study how to improve the state’s foster care system and provide additional support to families.

Several bills would expand access to the federally funded cash assistance program TANF in various ways. House Speaker Charles McCall, R-Atoka, filed a bill that would allow TANF applicants to still participate in the program after failing a drug test by adding substance use treatment and mental health counseling to program work requirements. 

In a letter to the task force, the Oklahoma Department of Human Services said it was missing opportunities to connect Oklahomans to services that help stabilize families by automatically denying benefits because of a failed drug test. 

Another bill would get rid of a rule that prevents families with a car valued more than $5,000 from receiving TANF and instead allow one car per household.

Other bills propose expanding access to maternal health care for Medicaid recipients by raising provider rates.

Oklahoma had the 10th-highest rate of poverty in the U.S. in 2021, and one in five Oklahoma children lived in poverty, according to U.S. Census Bureau data. In fiscal year 2021, kids that left Oklahoma’s foster care system through adoption had spent an average 30 months in state custody, according to state data The Frontier previously reported. 

More than half Oklahoma’s 77 counties are classified as maternity care deserts, the March of Dimes reports. Black women in the state are more likely to die from complications during or shortly after childbirth or face life-threatening complications. 

Corrina Jackson is the program and project manager for Tulsa’s Community Service Council Healthy Start program. Her staff connect pregnant women to prenatal and postpartum care.

Oklahoma has historically been rated as one of the worst states to have a baby, Jackson said, especially for Black women. Families need better access to programs like TANF, as well as resources like breast pumps and more health care providers nearby, she said. 

Jackson says she welcomes any improvements lawmakers pass, but those improvements need to be paired with good communication to providers and support from the broader community. 

“It’s all part of coming out and making sure we’re walking together in this,” Jackson said. 

Among the HELP Task Force’s recommendations were calls to expand health services to women across the state, as well as broaden eligibility for pregnancy and postpartum coverage through SoonerCare.

The Oklahoma Health Care Authority, which oversees the state’s Medicaid program SoonerCare, has approved expanded Medicaid eligibility for pregnancy and postpartum care. The agency has asked for additional state funds in this year’s budget to cover those costs, as well as more funding to cover doula services, which could begin this summer.

The Oklahoma State Department of Health has requested an additional $2.9 million to hire 25 pregnancy resource navigators around the state to help improve immunization rates and access to nutrition and health care programs for some parents and babies, according to agency documents.

“It’s about tightening the network so Oklahomans don’t fall through the cracks,” state Health Commissioner Keith Reed told lawmakers at a budget hearing last month.

Senate Bill 594 would enhance reimbursement rates for providers that offer maternal health care in areas with low access. Prenatal care can help prevent low birth weights and infant deaths, according to the U.S. Office on Women’s Health

Several bills would increase the amount of money a person or agency can initially spend on a birth mother’s living and transportation expenses. 

Some bills target the need for better legal representation for biological families in the child welfare system, as well as expand education requirements for foster parents and address lengthy stays for kids in state custody. 

One lawmaker wants “any unborn child with a detectable human heartbeat” to be considered a dependent, and another aims to make the first instance of domestic abuse against a pregnant woman a felony. 

Sen. Carri Hicks, D-Oklahoma City, said she’s tried for several years to get legislation on maternal health in front of committees without success. 

Hicks is running bills to cover breast pumps under SoonerCare and reimburse baby-friendly hospitals at a higher rate, and legislation to create stricter guidance for state money paid to private organizations that help women decide to carry their pregnancies to term instead of choosing abortion. 

Hicks said she’s glad Oklahoma is finally making some of these issues a priority. 

“And yet, I couldn’t help but be frustrated and think if we would have addressed these issues three to four years ago, where would we be now?” she said.