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Oklahoma’s transition to managed Medicaid brings new benefits, challenges for providers, patients

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Oklahoma’s transition to managed Medicaid brings new benefits, challenges for providers, patients


Amanda Paul was inspired to become a speech-language pathologist because of her daughter, who experienced language and learning problems as a child. Now, Paul runs her own clinic in downtown Chickasha, where she serves mostly Medicaid families.

She uses shelves filled with toys to connect with kids with autism, Down syndrome and sensory issues, and she teaches them how to communicate. She does all of this while handling the day-to-day operations of her rural, independent practice.

“I do it all. I’m the secretary, the speech path, the janitor. It’s all me,” Paul said.

Paul said her job has become much harder in the past few months as the state transitions to managed Medicaid, or SoonerSelect. In a 10-month turnaround, the Oklahoma Health Care Authority (OHCA) went from paying providers to paying private companies to coordinate Medicaid care.

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The state contracted with the medical plans Humana Healthy Horizons, Aetna Better Health and Oklahoma Complete Health, which also runs Oklahoma’s Children Specialty Program. They went live April 1.

A month into the new system, Paul said she only received about 5% of the claims she sent out. She’s had to cancel client visits and spend late nights figuring out why she wasn’t getting paid.

“My blood pressure is normally under control. Last week, it was 191 over 101 because of the stress,” Paul said.

Jillian Taylor

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StateImpact Oklahoma

Amanda Paul and one of her clients, Ashlie Killman, at Paul’s practice in Chickasha

But she kept seeing patients. That was the case for multiple providers in mental health and occupational therapy, who told StateImpact they waited weeks to receive only small portions of their payments. They all continued seeing patients for free until they mostly resolved their issues with the plans. Paul said she’s still working on that. Even now, only one plan has given her some checks from May, while the other two have provided about half of them from April.

As of May 13, 616,224 Oklahomans on Medicaid are now seeing their medical care coordinated by private insurance companies instead of OHCA. Proponents say the change incentivizes preventative care and its rollout has been going well. But it has caused problems for some Oklahomans on Medicaid and the smaller providers, like Paul, who are serving them.

What is managed care and how did Oklahoma get it?

OHCA began its transition to SoonerSelect in 2022 after Gov. Kevin Stitt signed Senate Bill 1337 — authored by Sen. Greg McCortney (R-Ada) and Rep. Marcus McEntire (R-Duncan) — and Senate Bill 1396 — authored by McCortney and Rep. Kevin Wallace (R-Wellston).

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SB 1337 required OHCA to enter capitated contracts with entities to deliver Medicaid services. It left out the state’s aged, blind and disabled populations, meaning they will still be served under the OHCA-led Medicaid program, SoonerCare.

SB 1396 added to an already existing Supplemental Hospital Offset Payment Program, which taxes hospitals and uses collected fees to attract more federal money. That total is redistributed to participating hospitals. The bill brought an opportunity to invest additional funding into hospitals, and they received an accelerated payment of $252.4 million in April.

Since those bills were signed, OHCA has been working to make providers and members aware of the transition through things like newsletters, social media posts, town halls and provider meetings.

SoonerSelect health plan enrollment began Feb. 1 and ended March 10, and if members didn’t actively choose a plan, OHCA enrolled them in one on their behalf. OHCA’s Public Information Officer Emily Long said at the end of open enrollment, about 20% of Oklahomans had actively chosen a plan.

Oklahoma’s Medicaid Director Traylor Rains said to help the agency maintain its oversight role, OHCA created a 20-person operation division that specifically focuses on SoonerSelect. They also brought on some consultants to help them meet the needs of managed care.

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Long said the transition to SoonerSelect allows Oklahoma to achieve goals like improving health outcomes, customer satisfaction and investing in preventative primary care. Each of the plans offers a list of unique benefits, including monetary incentives for attending well-child and primary care visits, making care managers available to members and waiving copays for certain services.

The Oklahoma Health Care Authority manages Oklahoma's Medicaid program, known as SoonerCare.

The Oklahoma Health Care Authority manages Oklahoma’s Medicaid program.

Problems for providers

Rains said the state’s contract requires the insurance companies to pay 90% of all clean claims in 14 calendar days.

“That claim coming into the managed care plan has to have the right provider information on it … and match all the editing criteria,” Rains said.

The operation team receives reports from companies that it will use to verify if plans meet that target. If they don’t, they could face monetary penalties.

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The Oklahoma Health Care Authority found challenges early in the transition, including errors in processing claims and issues with direct deposits and call centers. They sought to address those through multi-week office hours with the plans and provider-specific town halls. Plans also offer advance or interim payments to providers experiencing cash flow issues.

StateImpact reached out to Oklahoma’s three medical-managed care plans about the transition. Humana Healthy Horizons interviewed with StateImpact. Aetna Better Health and Oklahoma Complete Health sent statements. Those are included at the end of the article.

Humana Healthy Horizons in Oklahoma CEO Joseph Fairbanks said 99.9% of the plan’s clean claims are being paid out in 14 days, and their average for claims processing is within six days of receipt.

Some of the issues Paul said she struggled with included getting her claims for one plan through the online provider portal, Availity. She also found out later that she had been billing incorrectly for another plan. Those issues took a lot of late nights to solve, and she said she’s still stressing week to week as she waits for more payments to come in. She’s had to consider closing down at points.

Fairbanks said although overall feedback has been positive from providers, certain ones, like Paul, are more likely to have issues.

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“By their nature, because they’re either individually run provider clinics or they have a smaller staff, they don’t have as many resources as some of the larger providers did to prepare. So we have to help them substantially more than we do some of the larger providers,” Fairbanks said.

The Oklahoma State Medical Association President Dr. Edgar Boyd said it can be challenging for providers to have to choose between paying their bills and serving their patients. It’s a choice, he said, they don’t want to have to make as the transition continues.

“I don’t want to see patients cut off from access to care, just because their provider can’t afford to float the loan any longer,” Boyd said.

Problems for patients

Boyd, a practicing otolaryngologist in Muskogee, said despite communications from OHCA, he worried his Medicaid patients weren’t prepared.

“I would see patients in my office in early March and ask them if they had selected their new insurance company for their child,” Boyd said. “‘Oh no, we have SoonerCare Medicaid.’ I go ‘Well it’s changing come April 1st.’ ‘Oh, we didn’t know anything about that.’”

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Stillwater resident Donna Waldrop said she tried to prepare as much as she could before the transition. Waldrop receives Medicaid as a live-in caregiver for her best friend, and she chose Humana Healthy Horizons because most of her doctors were taking it. But she said she had to change some of her specialists because they didn’t take Humana.

Specialists like her rheumatologist. She said they canceled her appointment the day before in May despite a 90-day continuity of care period required by the Oklahoma Health Care Authority. This means that Oklahomans should be able to see their regular providers through June even if they’re contracted with a different insurance than what they chose.

That meant she had to push back getting surgery for a torn ligament in her hip because she needed the specialist’s approval.

“I am just beside myself because I had all these things planned out, specialists I was supposed to go see in May to try to get my hip done by the summer. Because I am a caregiver. I have to plan this out very carefully. … I probably will have to live with this for at least another year,” Waldrop said.

Waldrop said she will also lose her psychiatrist because the company they work under will no longer take Medicaid after the continuity of care period. A company spokesperson from Lifestance, an online behavioral health company, told StateImpact why in an email:

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“We work hard with each insurer to ensure sustainable levels of investment in mental health care. Unfortunately, the significant regulatory burden associated with accepting SoonerCare, combined with reimbursement levels that do not cover the cost of care, made it impossible for us to continue to contract with SoonerCare at the moment. We remain committed to continuing to engage with the state to identify a sustainable path forward for mental health care.”

Waldrop said as of late May, she changed her plan to Oklahoma Complete Health, allowing her to get a delayed appointment in July with her rheumatologist. She said she’s worried about further delaying surgery for both herself and her friend.

“It is eventually going to cause me to not be able to work if it gets worse. … This is the kind of injury that needs surgery to fix. If not, you live with it, and you become more disabled. If this is not fixed, I will need a hip replacement. I’m 45,” Waldrop said.

Positive potential

Although some providers and people say this transition has been difficult, others disagree. Stigler Health and Wellness Center CEO Teresa Huggins said they felt prepared for the transition and supported by the plans.

She looks forward to seeing the impacts this model could have on preventative care through some of its added benefits. Her goal is to use this transition to strengthen the center’s care model.

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“We hope that those outcomes will be better quality indicators, better health outcomes for them, and then that would result obviously in less cost to the state,” Huggins said.

Oklahoma’s Medicaid Director Traylor Rains said overall, the Health Care Authority feels this transition has gone as well as the agency could have expected on a short turnaround. Long said Oklahoma has improved from where it was at the beginning of April when the rollout of SoonerSelect launched.

“We are continuing to work with our partners at the plans and providers to resolve any other issues that come up because it’s very important for us for our providers to feel that they are supported and that we can help them in any way that we can,” Long said.

But as the transition continues, providers like Amanda Paul and patients like Donna Waldrop are dealing with the growing pains.

Statements from contracted entities

Aetna Better Health:
Aetna Better Health of Oklahoma is deeply committed to improving health outcomes for SoonerSelect members. We recognize that the state’s transition to managed care is significant and are working closely with our members and the state to ensure coverage is continued and enhanced for all SoonerSelect members both in the short and long term.

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-Aetna Executive Director of Communications Alex Kepnes

Oklahoma Complete Health:

Oklahoma Complete Health is excited about the opportunity to deliver innovative solutions to address the drivers of health, remove barriers to care and deliver better health outcomes for Oklahomans.

We believe primary care is the foundation of comprehensive health care. It is imperative that we educate our members about the importance of choosing and working closely with their primary care providers.

To assure continuity of care for members, Oklahoma Complete Health is honoring all OHCA prior authorizations.

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If a provider holds a current authorization issued by OHCA, no further prior authorizations requests need to be submitted unless notified by Oklahoma Complete Health.

-Oklahoma Complete Health Chief Medical Officer Dr. Lynn Mitchell

Additional Resources:

  • Oklahomans have until the end of June to change their plans. They can call 800-987-7767, option 5 to talk with choice counselors. 
  • OHCA SoonerSelect Contact: SoonerSelect@okhca.org
  • Provider resources are available on OHCA’s website 
  • Member resources are available on OHCA’s website

StateImpact Oklahoma is a partnership of Oklahoma’s public radio stations which relies on contributions from readers and listeners to fulfill its mission of public service to Oklahoma and beyond. Donate online.





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Why Oklahoma GM Jim Nagy Thinks a Freshman Salary Cap Would be a Good Idea

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Why Oklahoma GM Jim Nagy Thinks a Freshman Salary Cap Would be a Good Idea


The general manager role in college sports remains in its infancy. Oklahoma took a forward-thinking step by hiring Jim Nagy in early 2025 to model an NFL-style front office, but the evolving position still comes with its share of challenges.

“You don’t want to take a high school kid and pay them more than an All-American player/All-Conference player (on your roster),” Nagy said on the most recent episode of university president Joseph Harroz Jr.’s podcast, Conversations With the President.

On the episode, Nagy and Harroz addressed a number of topics but got into what the Sooner general manager hopes for the future — a freshman salary cap. That belief grew from something he learned early in the job.

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“One blind spot I had coming into the job was I didn’t think the players would talk as much, and share the information as much,” Nagy said.

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Oklahoma general manager Jim Nagy | Carson Field, Sooners On SI

That leaves Nagy trying to balance retention, compensation and recruiting without creating friction in the locker room — concerns that make Nagy believe a freshman salary cap is necessary.

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“If you wanted to, ‘fix’ isn’t the right word, but land in a good spot for the greater good of college football is some sort of freshman salary cap,” Nagy said. “That’s one of my biggest challenges. The acquisition costs out of high school is so high.”


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Nagy praised Oklahoma’s culture, noting that a key prerequisite for the job was ensuring he and his staff were in lockstep with Brent Venables’ vision for the program, something he said has come to fruition.

“You have to go after great players, you have to get the top talent,” Nagy said. “But right now, it can be at the expense of your culture, which coach Venables and the coaching staff have worked so hard to develop. If we had some sort of rookie/freshman cap, that would alleviate that issue.”

Despite these challenges, Nagy has integrated himself within Venables’ program and helped accent football’s mission of “adaptive and forward thinking.” He mentioned that during prep for Alabama last December, the front office was busy at work in attempting to retain their roster for the following season — something made easier by Venables’ leadership.

“Our ability to retain our starters, give our coaching staff a ton of credit, because our players want to be here.”

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Oklahoma coach Brent Venables | Carson Field / Sooners On SI

But Nagy understands any changes will take time. Until then, Oklahoma’s front office is building the best Brent Venables-led program it can, with championship aspirations and a clear understanding of how the current landscape works.

Still, he feels that his desired change would benefit the “greater good of the sport.” Oklahoma is prepared if that change comes sooner or later.

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“A CBA model, there is a model in place,” Nagy said. “At least for football, I’m not going to speak to the other sports, there is a model out there that has shown to work. We don’t have to completely copy and paste what the NFL does, but if we went to a similar structure, we could find a good spot.”

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When asked if that’s where he felt the sport would land — collective bargaining agreements — Nagy said “yes” with confidence.

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2026 NBA Playoffs: Oklahoma City Thunder at Los Angeles Lakers best bet, odds, prediction

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2026 NBA Playoffs: Oklahoma City Thunder at Los Angeles Lakers best bet, odds, prediction


Their end is inevitable, but the Los Angeles Lakers (0-3) can stave off elimination when they host the Oklahoma City Thunder for Game 4 of the 2026 Western Conference Semifinals.

At BetMGM, Oklahoma City opened as -500 on the moneyline (Los Angeles at +375) and -10.5 favorites. However, the flood of pro-Thunder money has steamed them up to -11.5 favorites at the time of writing.

THE REFS IN THE OKC-LA SERIES WERE SO BAD, THE LAKERS HAD TO HAVE A POSTGAME MEETING WITH THEM

Oklahoma City Thunder’s Shai Gilgeous-Alexander gets a layup vs. the Los Angeles Lakers in Game 2 of the 2026 Western Conference Semifinals at Paycom Center. (Alonzo Adams-Imagn Images)

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OKC has won every game this series by 18+ points and has a seven-game winning streak over LA. That’s despite reigning NBA MVP Shai Gilgeous-Alexander not putting up his typical crazy numbers.

Shai is scoring only 21.0 points per game in this series, slightly behind Thunder big man Chet Holmgren’s 21.3 PPG average, which leads the team.

 

LeBron James Is Trying To Avoid Another Sweep

LeBron James has only been swept three times in his career: the 2007 NBA Finals by the San Antonio Spurs, the 2018 NBA Finals by the Golden State Warriors and the 2023 Western Conference Finals by the Denver Nuggets.

FLOPPING IS RUINING THE NBA AND LEBRON SHOULD TAKE SOME BLAME FOR THAT

Maybe the sweep is a foregone conclusion, like the New York Knicks vs. Philadelphia 76ers series, but I’m counting on the Lakers dying on their sword and going out with honor.

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Los Angeles Lakers All-Star LeBron James shoots over the Oklahoma City Thunder in Game 3 of the second round of the 2026 NBA Playoffs at Crypto.com Arena. (Jayne Kamin-Oncea-Imagn Images)

Los Angeles held a first-half lead in Games 2 and 3 and still lost by 18 and 23 points, respectively. Granted, perhaps that’s just OKC playing with its food more than anything the Lakers are doing right.

Still, it’s something for L.A. to build on.

 

Lakers Need Oklahoma City’s Role Players To Cool Off

The Lakers are hitting 39.3% of their 3-pointers in this series. Unfortunately for them, the Thunder are shooting 42.3% from behind the arc.

But Oklahoma City’s role players are doing most of the damage from deep. Thunder guards Jared McCain, Cason Wallace and Isaiah Joe, along with big man Jaylin Williams, are a combined 25 for 41 from 3-point range, good for a ridiculous 61.0%.

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The Oklahoma City Thunder bench reacts after making a 3-pointer vs. the Los Angeles Lakers in the second round of the 2026 NBA Playoffs at Crypto.com Arena. (Jayne Kamin-Oncea-Imagn Images)

That’s not sustainable.

If these randoms hit fewer shots in Game 4, the Lakers can cover the spread.

 

Betting Market Is Overwhelmingly On OKC

Finally, 95% of the money at BetMGM is on Oklahoma City as of Monday morning, according to John Ewing.

While I’m not someone who bows at the altar of betting splits, 95% of people don’t beat the sportsbooks. We all know this.

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OUTKICK IS NOW ON THE FOX APP: CLICK HERE TO DOWNLOAD

I know that’s simple logic, but if you blindly fade teams this popular in the betting market, you’ll probably have a positive return on investment.

 

Best Bet: Los Angeles Lakers +11.5

_____________________________

Follow me on X @Geoffery-Clark, and check out my OutKick Bets Podcast for more betting content and random rants.

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Tulsa Race Massacre reparations is soul-redeeming work for the US, Oklahoma civil rights lawyer says

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Tulsa Race Massacre reparations is soul-redeeming work for the US, Oklahoma civil rights lawyer says


NEW YORK (AP) — It wasn’t until his junior year of college that civil rights attorney Damario Solomon-Simmons learned about a devastating massacre that took place in his hometown of Tulsa, Oklahoma.

His African American studies professor lectured about what is known today as the Tulsa Race Massacre — the days in 1921 when white mobs carried out a scorched-earth campaign against an outnumbered Black militia protecting the fabled Black Wall Street, a prosperous all-Black community.

“I actually told a teacher, ‘I’m from Tulsa. That’s not true,’” Solomon-Simmons recalled. “And of course, I was wrong.”

That day planted a seed for the then-aspiring attorney, who went on to lead a reparations campaign for the living survivors of the massacre and their descendants. Nearly 105 years later, no one has been compensated for what they lost, and none of the culprits have been held accountable.

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That fight for reparations is the subject of Solomon-Simmons’ first book, “Redeem a Nation: The Century-Long Battle to Restore the Soul of America,” which is intended as a blueprint for justice in historic atrocities that Black Americans endured but never received reparations for. The book hits shelves Tuesday.

After the massacre, more than 35 city blocks of the neighborhood known as Greenwood were leveled in fires, an estimated 191 businesses were destroyed, and roughly 11,000 Black residents were displaced. The state of Oklahoma declared the death toll to be only 36 people, although many historians and experts who have studied the event put the death toll between 75 and 300.

Greenwood, founded in 1906, had been a bustling city within a city, with Black-owned grocery stores, soda fountains, cafés, barbershops, a movie theater, music venues, cigar and billiard parlors, tailors and dry cleaners, rooming houses and rental properties.

“If you can ignore Greenwood, which was the beacon of Black prosperity and Black progress in the history of this country, then you can ignore Black people in general,” Solomon-Simmons recently told The Associated Press. “I think that’s why people around the nation are so focused on the work that we’re doing, because they understand what it means to all of Black America.”

Solomon-Simmons’s book comes just months before the United States will mark 250 years since its founding in 1776. That was 89 years before the institution of chattel slavery — meaning an enslaved person was held as legal property of another — was abolished. The civil rights attorney questions the idea that Americans can truly celebrate the country’s accomplishments when it has yet to pay reparations, which historians say informs modern day disparities in wealth between Black and white people.

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“We cannot talk about what America has been and will be, without making sure that these issues are discussed and we get reparatory justice for both” slavery and the Tulsa massacre, Solomon-Simmons said.

‘America has never had a soul’

In 343 pages, Solomon-Simmons does more than recite the history of the massacre or make a legal thriller out of his reparations campaign. For him, securing justice for the survivors and descendants of the massacre is also about healing a nation whose earliest promises of equality for all rang hollow.

“When I speak of repairing America’s soul, I do not mean restoring something that was once whole,” Solomon-Simmons writes in the book. “America has never had a soul. … There was no moral center to recover.”

He suggests that America’s soul cannot be repaired if it is forced to choose between rebuilding the nation or repairing Black America. They must do both, he says.

“The struggle for justice in Greenwood is not about returning to a mythical past. It is about proving whether America can build a soul at all through truth, through justice, through repair.”

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Reparations for slavery and other historical racial injustices has been debated in the U.S. since Reconstruction, through the Civil Rights Movement and for much of the 21st century. Jennifer L. Morgan, a professor of history at New York University, said such debates are complicated by the question of exactly who pays the reparations and exactly who receives the payment.

“I don’t think that we’re talking about individuals who owe anybody else reparations. I think we’re talking about states, about institutions, about the nation,” Morgan said. “America is still grappling with reparations because America is still grappling at the legacy of slavery, racial discrimination, Jim Crow, and violent exclusion of Black people from the body politic.”

Some opponents of reparations argue there are no living culprits or direct victims of enslavement, much less people with verifiable claims of harm that can be presented in a court of law.

Solomon-Simmons disagrees.

“We know who did the massacre — the perpetrators are still living in Tulsa,” he said referring to the city and the chamber of commerce, which plaintiffs alleged had a hand in obstructing Greenwood’s recovery.

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There is one remaining massacre survivor involved in the reparations lawsuit: 111-year-old Lessie Benningfield Randle.

“If we cannot get her reparations while she’s alive, for the massacre, it’s gonna make it that much harder for us to get reparations for enslavement, Jim Crow, redlining and all those things that we are owed,” Solomon-Simmons said.

Fight for Tulsa reparations continues

In the book, Solomon-Simmons reflects on what committed him to the reparations fight.

While in law school, he was introduced to high profile civil rights attorneys working for the Reparations Coordinating Committee – the late Harvard Professor Charles Ogletree Jr., who mentored Barack and Michelle Obama; and the late Johnnie Cochran, who is widely known for defending O.J. Simpson during his trial for murder of his ex-wife. Solomon-Simmons became a law clerk for the committee.

After witnessing Ogletree argue a Tulsa reparations case in federal court in 2004, Solomon-Simmons said the practice of law stopped being just a credential for speaking, writing, or teaching. It became a calling.

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In 2020, Solomon-Simmons led a lawsuit on behalf of 11 plaintiffs, including the last three known living survivors of the massacre, against the City of Tulsa and seven defendants. The suit was the first of its kind in state court and the first to get far enough to see a judge. In 2024, the Oklahoma Supreme Court dismissed the lawsuit. In the final days of the Biden administration, the Justice Department released a report saying it had determined there is no longer an avenue for criminal prosecution over the massacre.

But the fight continues, Solomon-Simmons says, for cash payment to Randle and other descendants, as well as the return of land stolen after the massacre and during a period of urban renewal in Tulsa.

In 2025, the city’s first Black mayor, Monroe Nichols, endorsed a broad proposal dubbed Project Greenwood, which calls for financially compensating Randle, funding a scholarship program for descendants of victims, and designating June 1 as Tulsa Race Massacre Observance Day.

Solomon-Simmons also runs the nonprofit Justice for Greenwood, which he founded a year before the community marked the centennial of the massacre in 2021.

“One thing I’ve learned from this work, and as a lawyer in general, is that people want justice,” he said. “People want reparations, but people (also) want acknowledgment. They want to be seen. They want people to understand that something happened to them and their family, and they want an apology.”

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Aaron Morrison is the race and ethnicity news editor at AP.



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