Yet again, a Red State that has fought Medicaid expansion under the Affordable Care Act is considering joining in the expansion, reports Forbes. In the Sooner State, it’s being pushed by low oil prices and state overspending.

Four things to know about the possible expansion:

1. The state could move 175,000 women and children into subsidized coverage while opening Medicaid to 628,000 working-age adults.

2. The cigarette tax might rise 146 percent ( by $1.50 per pack)  to help fund the  expansion.

3. The American Journal of Managed Care said that Oklahoma legislators who had  resisted Medicaid expansion said fiscal realities are driving the reconsideration. Oklahoma’s Medicaid chief, Nico Gomez, said that without expansion, rural providers would not survive and would have to relocate, the journal notes.

4. Talk of Medicaid expansion comes soon after hospitals launched an initiative to get  lawmakers to broaden  coverage under Insure Oklahoma, a state-run insurance program that helps provide health insurance to small-business employees and people who don’t have access to employer-sponsored insurance.