An estimated 681,834 Oklahomans are currently uninsured, according to data from the Census Bureau’s American Community Survey (ACS). The Tulsa World’s recent coverage of the issue states that in many Tulsa County neighborhoods, as few as 1 in 3 residents have health insurance coverage.
Statewide, approximately 18.6% of individuals in Oklahoma are uninsured. To put this in perspective, the 2008-2012 ACS Health Insurance Coverage estimates put Oklahoma in seventh place for the highest rate of uninsured individuals in the country. Texas has the highest, at 23% uninsured. Massachusetts has the lowest rate, with only 4% of their population uninsured.
Education and income are among the factors that predict insurance coverage. Around 62% of our state’s uninsured adults have attained the equivalent of a high school diploma or less. Educational attainment is a contributing factor to household income, and lower incomes seem to be a trend among the uninsured. Nearly 65% of Oklahoma’s uninsured, an estimated 440,072, live in households with an annual income of $49,999.00 or less, indicating affordability might be a factor.
The state’s high rate of uninsured individuals undoubtedly contributes to America’s Health Rankings® and the Annie E Casey’s KIDS COUNT Data Center giving Oklahoma low marks compared to other states in regards to health. Compared to the national average, Oklahoma has a higher than average rate of low-birthweight babies and children without health insurance, according to KIDSCOUNT ranking. The state also has high rates of obesity and diabetes, according to America’s Health Ranking®.
The high number of uninsured individuals, coupled with poor health measures, means Oklahoma stands to gain much from the reforms enacted under the Affordable Care Act (ACA). However, due to a number of factors, many Oklahomans may not immediately benefit from recent reforms.
Oklahoma was one of more than 20 states that declined federal funds intended to expand Medicaid eligibility to adults making up to 133% of the federal poverty level. The Oklahoma Policy Institute estimated this decision has cut off the chance to access affordable health care for around 131,000 uninsured adults in Oklahoma. Nationwide, this leaves 4.8 million Americans in a coverage gap, according to the Kaiser Family Foundation.
This coverage gap exists because, under traditional Medicaid eligibility standards, most childless adults falling below the poverty line do not qualify for Medicaid if they are not disabled. These same adults also fail to qualify for federal subsidies to purchase insurance on a health care exchange because the Affordable Care Act was designed in anticipation of all states expanding Medicaid for individuals below 133% of the poverty level.
Oklahoma also declined to build an online health insurance marketplace, returning a $54 million dollar federal grant meant to help with implementation. As a result, Oklahmans seeking private insurance must go through the federal healthcare marketplace, which was initially plagued with delays and glitches. Consequently, by November 30th only 1,673 Oklahomans had selected plans on the marketplace. Most states running their own marketplaces saw enrollment numbers far above Oklahoman’s, including smaller states like Rhode Island and Vermont.
Oklahoma’s overall health situation is not so different than that of Kentucky, according to the Oklahoma Policy Institute (OK Policy). However, OK Policy points out how Kentucky took a different approach, expanding Medicaid and building a state insurance marketplace for individuals. The early results show Kentucky is set to outpace Oklahoma in improving their rate of uninsured individuals. By November 30th, Kentucky had 13,145 citizens enrolled through their marketplace, compared to Oklahoma’s enrollment number of 1,673.
In an op-ed for the New York Times, Gov. Beshear of Kentucky explained the reality of his state’s health insurance situation and why his state embraced the ACA in his op-ed,
Right now, 640,000 people in Kentucky are uninsured. That’s almost one in six Kentuckians. Lack of health coverage puts their health and financial security at risk. They roll the dice and pray they don’t get sick. They choose between food and medicine. They ignore checkups that would catch serious conditions early. They put off doctor’s appointments, hoping a condition turns out to be nothing. And they live knowing that bankruptcy is just one bad diagnosis away. ”
It is safe to say, that for many uninsured Oklahomans, this analysis is equally valid.