Medicaid Expansion Is Put to the Test and Oklahoma is in the Control Group

When researchers test a new medicine or even a new program design, they often devise a study comparing results between a treatment group and a control group. People in the control group receive no treatment, and forgo any benefits if it is proven to work and avoid any side effects if proven harmful.

A trial is going on regarding healthcare in this country, and right now Oklahoma has put itself in the control group. In this case, being in the control group may not be in our state’s best interest. However, it will provide useful comparisons between our state and states that chose to expand Medicaid.

In 2012, in the same decision where the Supreme Court ruled the bulk of the Affordable Care Act (ACA) was constitutional, the court also ruled that the federal government could not force the states to accept the Medicaid expansion. The Medicaid expansion was intended to provide healthcare coverage for Americans whose income fell below 133% of the poverty level.

While the court ruled the federal government could not force states to expand Medicaid eligibility, it did keep the option alive for states willing to accept federal money for the expansion. In essence, the final decision on expanding Medicaid fell to the individual states.

However, declining the expansion does not leave states in the same situation they were in before the ACA was passed.  In 2014, all states will begin to see a decline in the Disproportionate Share Hospital (DSH) payments the federal government grants to states to fund care for indigent patients.

States used DSH payments to help hospitals deal with unpaid medical bills, and DSH payments are decreasing because Medicaid was supposed to fill the gap. So it is important to understand that declining additional Medicaid funds leaves many hospitals at a financial disadvantage.

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Summer 2014 Food Programs for Children

School will soon be out for many Tulsa students, and for families struggling with food insecurity this can mean an added strain on the budget. To address this need, the USDA’s Summer Food Service Program provides meals during the summer break.

Nationwide, 2.28 million children participated in the program in 2012 and 39,000 sites across the country helped distribute nutritious meals to children. Participation has grown in recent years. Yet, studies estimate the program still does not reach the majority of children who qualify for assistance under the National School Lunch Program during the regular school year.

The USDA allows for different types of eligible sites under the Summer Food Service Program. Both types of sites depend on standards for free and reduced lunches set by the National School Lunch Program. Students are eligible for free lunches if their household income is at or below 130% of the poverty level. Students from households with income between 130% and 180% of the poverty level qualify for reduced priced lunches.

Under the Summer Meal Service Program, there are “Enrolled Sites,” where each family must fill out an application and the site must

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Saving for Retirement: Anti-Poverty Measures for the Golden Years

Right now, the poverty rate for Americans age 65 or older is lower than the rest of the population, but that could change. A 2012 Employee Benefit Research Institute (EBRI) report studied poverty trends in age groups over 50 and found in 2009 about 11% of adults over the age of 65 were living in poverty. However, for Americans 85 and older the figure was almost 15%. According to the report’s author, Sudipto Banerjee.

As people age, personal savings and pension account balances deplete. The total Social Security benefit received by a family is reduced with the death of a spouse. These factors potentially lead to rising poverty at older ages. Also, as people age, their medical expenditure increases steadily.”

Americans are living longer, and it sometimes brings financial problems along with extra years. And younger generations saving for retirement may face additional complications.

Social Security income helps alleviate poverty among retired Americans, but does not eliminate it. In the past, financial experts referred to Social Security as part of a “three-legged stool.” The metaphor explains how Social Security alone will not be enough and individuals also need private savings and company contributions to make up the second and third leg of the stool.

Today we are more likely to hear financial experts talk about Social Security as a foundation, particularly because traditional pension plans are vanishing. But overall, the idea is the same; Americans need to be saving more on their own for retirement. Unfortunately, Americans are falling so far behind in retirement savings, some experts are calling it a crisis.

Saving for retirement has become complicated because

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Census Data Shows Thousands of Oklahomans Lack Health Coverage

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.

U.S. Census Bureau, Public Information Office

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

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Millions Are Working Full-Time for Poverty Wages

Poverty is not isolated to families where adults are unemployed or underemployed. According to 2011 data from the National Center for Children in Poverty, 33% of children living in poverty in Oklahoma have at least one parent who works full-time, year-round.

Oklahoma also has one of the highest proportions of hourly paid workers earning at or below the federal minimum wage in the country, at 7.2%. Only Idaho and Texas have higher rates. And escaping poverty level wages is not as easy as applying for a new job. The Alliance for a Just Society released a report December 4^th that found,

“For every projected job opening above a low-wage threshold of $15 an hour, there were 7 job-seekers in 2012.”

Furthermore, while jobs lost during the Great Recession were not exclusive to any one sector, a 2012 report from the National Employment Law Project confirms most job losses were concentrated in mid-wage occupations. In contrast, the recovery has seen gains in the number of lower-wage occupations.

Low-wage occupations that increased during and after the recession include “retail salespersons, food preparation workers, laborers and freight workers,

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SNAP Cuts: The Countdown Has Begun

As I write this, we are less than 3 days away from dramatic spending cuts for the Supplemental Nutrition Assistance Program (SNAP). Nearly 48 million Americans rely on SNAP benefits, and every one of them will see a decrease in monthly benefits beginning November 1^st.

           

Dottie Rosenbaum, writing for the Center on Budget and Policy Priorities’ (CBPP) Off the Charts blog, puts the real life cost into perspective.

A household of three, such as a mother with two children, will lose $29 a month — a total of $319 for November 2013 through September 2014…That equals about 16 meals a month for a family of three based on the cost of U.S. Agriculture Department’s “Thrifty Food Plan.”

Of course, the potential for further cuts does not end at the first of November.  The much debated Farm Bill is still being considered

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The Poverty Rate is Just the Begining of the Story

Every year, the U.S. Census Bureau issues a report on annual poverty data from the American Community Survey. Last month, the Census Bureau reported the poverty rate for 2012 was 15%, virtually unchanged since 2011. For Oklahoma, the rate was 17.2%, also the same as last year.

When the current poverty rate is measured against the historically low rate of 11.1% in 1973, the news seems disheartening. Yet, as Sheldon H. Danziger points out in a recent New York Times opinion piece, comparing 2012 to 1973 without further context can give people the wrong idea about the true state of the war on poverty.

One thing to keep in mind is that poverty measures do not capture all the relief provided to low-income families under current safety net policies. Non-cash benefits,

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Smarter Kids & Healthier Americans: Using a Tobacco Tax to Fund Early Learning

Health and education are more related than some may think. Researchers have long noted the connection between a person’s level of education and health outcomes. Generally, more education leads to a reduced risk of heart disease and diabetes, according to the National Poverty Center.

However, the link between education and health outcomes is complicated, with a host of factors causing mortality rates to differ depending on the highest grade or degree a person completes. Still, there are proactive steps we can take to address both issues. Through public policy, we can link education and health in a way that clearly benefits both causes.

The idea that has policymakers and advocacy groups buzzing is the possibility of connecting early childhood education to strategies that reduce tobacco use. These two goals were brought together in the President’s 2014 Budget proposal, which seeks to expand access to high quality preschool programs and fund the initiative with an additional tax on tobacco products.

Nine organizations focusing on early learning or public health have come together to release a report supporting the proposal, Raising Smart, Healthy Kids in Every State. Organizations behind this effort include the American Heart Association, Save the Children

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Public Service Loan Forgiveness: A Rewarding Way to Pay Off College Debt

There is growing concern about the amount of student loan debt in the U.S, with the Consumer Financial Protection Bureau (CFPB) warning that more than $1 trillion is owed on outstanding loans.  The reason behind this record amount of student debt is tied to the rising cost of college and the increase in college enrollment.

While a college degree is still a worthwhile investment, the debt today’s graduates accumulate can impede their financial stability for decades after they leave school.  In fact, it can leave many young people with the impression they can’t afford to take a job in public service, such as teaching, because it doesn’t offer a salary high enough to pay off their loans. This reality drives talent away from public service, and is one of reasons the CFPB  and others are trying to raise awareness of loan repayment and forgiveness options (See: Public Service & Student Debt).

According to the CFPB, the cost of attending a public university in the U.S. has increased 42% in the last ten years, and for private universities the cost rose 31% for the same period.

Yet even in the face of rising costs, more people are attending college.  In the last 20 years, college enrollment has risen from 13.8 million to 21 million.  Pew Research now estimates 19%, or one out of five, American households owe outstanding student debt as of 2010.

As worrying as the cost of a college education may be, there is still value in it.  Last year

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The August Recess Has Begun and SNAP Funding (Still) Remains Uncertain

In May I wrote about upcoming cuts to the Supplemental Nutrition Assistance Program (SNAP) and said it was anyone’s guess where a compromise would leave the program. Now August is here, Congress is in recess, and still nothing has been done to stave off cuts scheduled for November; cuts that will lead to a decrease in benefits for nearly 652,000 Oklahomans.

Further cuts still seem inevitable. For the first time since 1973, the House of Representatives approved a version of the Farm Bill without including provisions for SNAP benefits at all. Since then, reports say the House has begun working on a plan to propose cutting $40 Billion from SNAP. This effectively doubles the cuts they proposed in their failed attempt to pass a Farm Bill in June.

Still, the Senate has yet to act on the House’s version of the Farm Bill, so the fight is not over. However, the Food Research Action Center (FRAC) is justifiably alarmed by recent developments, seeing them as an “assault on SNAP.” Robert Greenstein, President of the Center on Budget and Policy Priorities, issued a statement on the subject last Friday calling the new proposal “stunningly harsh.” And while the policy debate on further cuts goes on in Washington, the current Farm Bill is set to expire in September.

The future of SNAP is unknown, but the history of the program is not. And to fully appreciate why SNAP is a vital part of the government’s safety net, it is important to look at this issue from a historical and scientific perspective. Why do we have food programs, including SNAP, in the first place?  Why are these programs still needed today?

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