While the new federal health law has expanded consumer guarantees for minimum health benefits, Oklahoma is poised to move in the opposite direction. Embedded in an ‘interstate compact’ bill to allow out-of-state insurers to sell policies in Oklahoma is a provision that could nullify several of the state’s existing consumer protections. Language in SB 1059 appears to exempt both out-of-state and in-state insurers from state laws regarding minimum coverage and benefits offered by health insurance policies.  This bill would turn back the clock on our health care system and deprive Oklahomans of essential medical care that they rely on their insurance to provide. Read the rest of this entry »

The Affordable Care Act, the federal health care law that takes full effect in 2014, is expected to provide health insurance coverage to over 335,000 uninsured Oklahomans and reduce the state’s uncompensated health care costs by more than two-thirds , according to a new report from the Robert Wood Johnson Foundation (RWJF).

Currently, some 597,000 Oklahomans, or 19 percent of the non-elderly population, lack health insurance. Under the Affordable Care Act (ACA), the number of uninsured is projected to fall by 57 percent to 259,000, or 10 percent of the non-elderly population. Oklahoma’s 57 percent drop exceeds the national average of 48 percent and is the tenth highest drop among the states.

The researchers, who are health care policy experts at the Urban Institute, use the Health Insurance Policy Simulation Model to build projections of how coverage will be affected by the new law. For Oklahoma and for the nation, they find that the ACA will lead to more people with both public and private health insurance. Specifically, they project that: Read the rest of this entry »

In Oklahoma, more than one in four households are “asset poor,” meaning they have little or no financial cushion to rely on if unemployment or another emergency leads to a loss of income, according to a report released today by the Corporation for Enterprise Development (CFED).  Asset poverty is distinct from and broader than income poverty, which measures the amount of money a household receives during the year.  According to the U.S. Census, about one in six Oklahomans were income poor in 2010.  Andrea Levere, president of CFED, highlights asset poverty as a significant barrier to long-term financial stability:

Growing numbers of Americans have almost no savings or other assets to fall back on if they lose their jobs or face a medical crisis.  Without those savings, few will be able to invest in a more economically secure future, including buying a home, saving for their children’s college educations or building a retirement nest egg.

The 2012 Assets & Opportunity Scorecard offers a comprehensive look at Oklahomans’ ability to build wealth, fend off poverty, and create a more prosperous future. The Scorecard compares states along 52 different measures of how residents fare in five issue areas: Financial Assets & Income, Businesses & Jobs, Housing & Homeownership, Health Care and Education. Read the rest of this entry »

What’s up this week at Oklahoma Policy Institute? The Weekly Wonk is dedicated to this week’s events, publications, and blog posts.

This week OK Policy explained what federal budget cuts could mean for Oklahoma.  Doug Hall of the Economic Policy Institute underscored the urgency of fixing America’s crumbling infrastructure.  Our director David Blatt spoke at a StateImpact Oklahoma forum about why proposals to reduce or eliminate the income tax would effectively raise taxes for most Oklahomans.

Also this week, we featured remarks by Maryland Governor Martin O’Malley on how health care reform improves business competitiveness.  We posted event information about the first annual Grandparenting Workshop at Oklahoma State University.

Numbers of the Day

• $107 – Average tax increase on sixty percent of Oklahoma households under a legislative proposal to eliminate a slate of broad-based tax credits and exemptions.
• 8,600 – Number of jobs lost in state and local government in Oklahoma over 2010.
• $22,007 – Annual average wage for home health aides in Oklahoma, just below the federal poverty level for a family of four in 2010, $22,050
• 11 percent – Percentage of ex-offenders released in Oklahoma who were re-incarcerated for technical violations of their probation/parole in 2004, up from 3 percent in 1999.
• $34 million – Amount needed to repair sewer lines and make major improvements to two facilities slated for closure that house medically fragile, mentally disabled Oklahoma residents.

In The Know, Policy Notes

• The Center for Economic and Policy Research shares five reasons we should be concerned about the rising share of low-wage work.
• Touchstone examines the austerity curve, or the point at which cutting government spending becomes self-defeating because it lowers growth, depresses tax revenues, and pushes up social security spending by more than the government is cutting.
• The Century Foundation shares a series of graphs that bust the myths about food stamps.
• The Kaiser Family Foundation released their annual survey of employer health benefits, with a detailed look at trends in employer-sponsored health coverage.

Is it the role of government to put policy in place to impact the overall health of our citizens?  As the Oklahoma legislature’s interim study committee prepares its final report on the state’s obligations under the new federal health care law, the co-chairs have posed a series of questions to committee members to elicit thoughts, opinions, and lessons learned.  This post responds to a central theme of those questions, a theme we think has implications for the state’s future prosperity well beyond the new health care reform law.

Let’s assume that you stand on principle that it’s not the government’s role to engage the health care system.  Then we have a gravely serious problem.  We are very nearly the unhealthiest state in the country and we’re getting worse.  Individual behaviors – smoking, diet, fitness - certainly affect health, but it’s by no means certain that they’re the most important factors.  What we’re facing in Oklahoma is bigger than the sum of each individual resident’s health choices.  Acute structural defects in the state’s health care system demand solutions that are bigger than each of us and addressing them will benefit all of us. Read the rest of this entry »

Julie is an Associate Professor and Assistant Director of the Anne and Henry Zarrow School of Social Work.

The number of uninsured individuals in Oklahoma has reached approximately 600,000 individuals. Almost half of Oklahoma’s uninsured are between the ages of 19-34. Despite this high number, little is known about why these young adults are underinsured or what strategies might encourage them to obtain coverage.

A state-wide survey and focus groups were designed to capture the opinions of young Oklahomans ages 19-34 regarding access to and the use of Oklahoma’s health care system in the absence of health insurance. Although it has been suggested that the young adults believe that they do not need health care coverage, results of the survey suggest otherwise. Read the rest of this entry »

Jeffrey Alderman, M.D., is an associate professor in the Department of Internal Medicine at the University of Oklahoma School of Community Medicine in Tulsa.

With Medicaid cuts looming and the federal government entertaining efforts to shift the costs of Medicare and Medicaid on to states and individuals, the future of health care reform and reimbursement seems murkier now than ever. But gaining little attention is the issue of physician workforce. In other words – with the size and scope of our health care provider pool now shrinking, how will we meet increasing patient demand with our current available workforce?

Despite our best efforts, we simply cannot attract new physicians to the state, and a large percentage of our OU/OSU graduates leave to work outside of Oklahoma. This helps to explain why in 2009 the Commonwealth Fund ranked Oklahoma 50^th in the nation for health status and health system performance. Similarly, a 2007 American Medical Association report found that Oklahoma ranks last in the US in physicians per capita, perhaps revealing why there is a 14-year difference in life expectancy between some north and south Tulsa communities. Read the rest of this entry »

The U.S. House or Representatives is expected to vote tomorrow on a federal budget proposal for the coming year that would —  among other things —  force drastic cuts to Medicaid that would harm Oklahoma seniors, people with disabilities, and children.  The budget plan, introduced by Republican Congressman Paul Ryan of Wisconsin, would also shift costs and risks onto our state and likely would force the state to cut payments to hospitals, nursing homes, physicians, and pharmacies.

Medicaid  is a primary source of health insurance for seniors, persons with disabilities, and children. Medicaid is especially important for Oklahomans receiving long-term care  in their homes or in nursing home facilities. It is also a cornerstone of the health care system for hospitals, physicians, pharmacies, nursing care facilities, home health care providers, and other professionals and businesses across the state. About one out of every five Oklahomans – close to 700,000 people -  receive health insurance coverage through Medicaid.

The Ryan proposal would turn Medicaid into a block grant.  Instead of covering a fixed share of a state’s Medicaid costs, the federal government would write a check each year. It would dramatically cut the amount of money it gives to a state, and that cut will grow bigger and bigger every year.  In total, states would receive $771 billion less over the next ten years under the Ryan plan; Oklahoma would lose some $8.2 billion, according to projections from Families USA. Read the rest of this entry »

Today is the one-year anniversary of President Barack Obama signing into law the landmark Affordable Care Act (ACA).  Many of the most far-reaching provisions of the health care reform law – including the launch of new health insurance exchanges for individuals and small groups, subsidies for the purchase of individual coverage, expansion of Medicaid eligibility, and the individual coverage requirement- do not take effect until January 1, 2014. However, some provisions of the law are already improving health insurance, expanding coverage to new populations, and making insurance more affordable. According to a fact sheet from Families USA, Oklahomans have already benefited from health care reform in a number of ways:

• Over 50,000 uninsured Oklahomans under the age of 26 are now eligible to remain on their parents’ health insurance plans;
• Some 50,000 Oklahoma Medicare recipients received a $250  rebate check in 2010 to help plug the “doughnut hole” in prescription drug coverage. In 2011, those who reach the doughnut hole will receive a 50 percent discount on brand-name drugs and will be eligible for reduced-price generic drugs;
• Nearly 600,000 Oklahoma seniors and persons with disabilities on Medicare now enjoy access to free preventive services, such as mammograms, colonoscopies and flu shots, along with a free annual wellness visit;
• Over 65,000 Oklahoma children with pre-existing health conditions can no longer be denied coverage by their insurance company;
• Some 50,000 Oklahoma small businesses with 25 or fewer employees and an average wage of less than $50,000 are now eligible for tax credits to help cover up to 35 percent of the cost of health insurance premiums for their employees. Read the rest of this entry »

Another budget year, the same sad story: The combination of tax cuts and the recession results in severe cuts to public services.

Over the past two years, most agencies have lost 15 percent or more of their funding. Even though state appropriations as a share of the economy is at a 30 year low, next year’s shortfall is projected at $500 million. The Governor’s proposed budget for next year would eliminate some agencies and take another 3 to 5 percent from the rest.

Last year we surveyed some of what’s been lost. Here’s an update:

• With personnel costs making up 93 percent of its budget, more cuts to the Public Safety Department will mean furloughs and possibly laying off troopers. The Department already has 110 fewer employees than 2 years ago, and more than half of the drivers’ license testing sites across the state have been closed. A portion of these funds are being replaced by increasing the fee to reinstate a driver’s license. Read the rest of this entry »

This is the seventh in an ongoing series of posts examining the Affordable Care Act, including previous posts on the Temporary High Risk Pool, health insurance exchanges and tax credits for small businesses.  You can also visit the health care reform page on our website for more resources and information.  If you have thoughts on health care reform, we encourage you to comment below or contribute a guest blog.

It’s been almost a year since President Obama signed major health care reform legislation into law.  On the opening day of Oklahoma’s 53rd legislature, Governor Fallin made it clear that her administration would join other state’s in challenging one of the most controversial parts of the Affordable Care Act (ACA):

Many Oklahomans, including myself, feel that the federal mandate is unconstitutional and wrong. That’s why Attorney General Scott Pruitt and I have acted to add Oklahoma to the list of states that are now challenging the president’s health care law in court.

How does the governor’s – and by extensions the state’s – stance on the individual mandate affect the myriad other ACA changes?  For now, their position has no effect on the millions of dollars allocated to the states under the new law to address acute health care needs.  Beyond the individual mandate, which goes into effect in 2014, the ACA asks the states to make fundamental improvements in health care infrastructure and expand insurance coverage to the 671,663 Oklahomans who are currently uninsured. Read the rest of this entry »

From time to time, we use the OK Policy blog to post submissions we receive from Oklahomans who have interesting perspectives on important policy issues for the state. This entry is from Adam Kupetsky, a resident of Tulsa .

Even after the worst financial crisis since the Great Depression almost sank us into a second Great Depression, some politicians still believe that “no regulation” is the answer.  Regardless of the industry concerned, politicians with lobbyists’ money in their pockets or ideologies to prove correct find reasons to oppose effective regulation and make it possible for free market excesses to reduce our confidence in the free market.

Opposition to regulation in any form is just as radical and crazy as a socialist’s complete opposition to the market.

The truth is that Americans want the market to be left alone when it works and for the government to step in and regulate when the market doesn’t work.  Health care is one example where the market has not worked completely and requires some government regulation of private insurance companies.  Absent some government regulation of health care, insurance companies have shown that they will not provide coverage to those with pre-existing conditions, will impose lifetime spending caps, will deny coverage to the sick and will keep prices unreasonably high. Read the rest of this entry »