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 »

Our health care system is experiencing an unprecedented period of upheaval. Decades of rising costs, an ever-increasing share of citizens without insurance, and an aging baby boom generation are putting immense pressure on payers, providers, and patients alike.  A new policy brief from Oklahoma Policy Institute underscores the importance of SoonerCare/Medicaid as the primary safety net health care program for low-income Oklahomans who would otherwise go uninsured, primarily children, the elderly, and persons with disabilities.  The five-page brief, Medicaid 101: The SoonerCare Safety Net, outlines the program and its eligibility requirements, breaks down its funding sources, and debunks common Medicaid myths.

One popular myth is that Medicaid costs are rising exponentially and the program is riddled with waste.  In fact, scholarly research has demonstrated that Medicaid costs about 20 percent less on average per person than private insurance, so the program is quite lean.  While it is true that health care costs are rising, it’s important to remember that they are rising across the board, not just for the Medicaid program.  The state can also take advantage of a favorable federal matching rate to leverage their health care investment.  For every $1.00 the state government invests in SoonerCare in FY 2012, the federal government will contribute $1.77. Read the rest of this entry »

Under the new national health care law, the Patient Protection and Affordable Care Act (ACA), one major strategy for providing health insurance coverage to the 50 million Americans who are currently uninsured is an expansion of eligibility in the Medicaid program. Even though the federal government will assume the lion’s share of the costs of insurance for those who gain Medicaid coverage, this expansion has created concern and uncertainty about the impact the law will have on state budgets.

We do not yet have a comprehensive study of the projected costs and savings of the Affordable Care Act for Oklahoma’s state budget. However, as a new OK Policy issue brief shows, most studies of the impact of the Affordable Care Act have concluded that increases to state Medicaid budgets will be modest. National studies from the Urban Institute and projections developed by the Oklahoma Health Care Authority have estimated that state spending on Medicaid may grow by $200 to $800 million between 2014 and 2019 or 2020, depending on various assumptions, while increasing state Medicaid spending by under 10 percent.  The federal government will assume over 90 percent of total costs of expanded Medicaid coverage. To cite the conclusion of the study by John Holahan and Irene Headen, the Urban Institute’s experienced and widely-respected health policy analysts: Read the rest of this entry »

This article is co-authored by Dr. Kristen Marie Burkholder, Dr. James Cane-Carrasco, Dr. Douglas Catterall, Elizabeth Powers, Rev. Scott Scrivner, and Dr. Tony Wohlers. For the authors’ longer study of the American health care system, click here.

On March 23^rd, 2010 President Obama signed into law a sweeping reform of the U.S. health care system.  Since that time some have taken action to repeal these reforms, others have indicated support for extending them.  Much of the talk opposing or supporting reform has been remarkably free of the perspective of those who would benefit most from it: the uninsured, the underinsured, and those who may soon enter their ranks. We are writing to address an injustice that the citizens of the United States, the country of our birth or adoption, are inflicting upon themselves.

Let’s first show the health care system working at its best.  Recently, a colleague of ours became ill and physicians suspected the worst: a brain tumor that might be near or actually embedded in her speech center.  Our colleague received incredible support from family and friends and our employer offers first-rate health insurance, giving her a choice of clinics, hospitals, and specialists.  She chose MD Anderson in Houston whose physicians and staff provided her with the excellent care. Happily, the neurosurgeon who operated on her found no tumor and she has returned to work.  However, this best-case scenario could have turned out differently. Our current health insurance provider, Blue Cross/Blue, Shield., covered the roughly $58,000 cost of our colleague’s treatment. But, with our previous health provider, MD Anderson would have been an out-of-network, leaving our colleague with more of the costs. Read the rest of this entry »

As states and Washington grapple with ongoing budget shortfalls, the Medicaid program is often in the crosshairs of those calling for major reductions in government spending. But while the costs of funding Medicaid are readily apparent, we should not forget the program’s crucial role in providing health care for those who may be too poor or too unhealthy to buy coverage in the commercial insurance market. Recently, a path-breaking new study reported that when those without health insurance are enrolled in Medicaid, they see wide-ranging benefits in terms of access to health care services, better physical and mental health, and financial stability. These findings should assume great importance in ongoing state and federal debates on Medicaid and health care reform.

Medicaid is the primary source of health insurance for low-income children, pregnant women, seniors, and individuals with disabilities. The federal-state program covers 47 million Americans, or just under one in five of all those with health insurance coverage (2009). In Oklahoma, 728,594 persons are covered by Medicaid as of May 2011; the majority (63 percent) are low-income children. Medicaid is administered by the states with the federal government assuming a majority share of the costs. 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 »

This is the sixth in an ongoing series of posts examining the Affordable Care Act, including previous posts on the Temporary High Risk Pool 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.

One of the most important provisions of the federal health care reform law, officially known as the Affordable Care Act (ACA), is the requirement that states establish private insurance marketplaces, or ‘Exchanges’, to sell plans to individuals and small groups in their state.  Health insurance exchanges were written into the law to ensure that these particularly vulnerable segments of the market – individuals and small groups – could obtain affordable coverage.  What is unique about these segments?  Well, consider how insurance works for a large group employer:  every employee is covered regardless of medical history and all employees pay roughly the same premiums.  This is possible, and perhaps more importantly profitable, because the risk of covering the sicker/costlier employees is offset by the ease of covering healthier/cheaper employees. Read the rest of this entry »

The U.S. Census Bureau today released its annual report on income, poverty, and health insurance coverage for 2009 based on its March Current Population Survey.  The data reflected the severity of the recession throughout 2009: the national poverty rate rose from 13.2 percent to 14.3 percent, as an additional 3.7 million Americans in 2009 lived in households with income below the federal poverty level (just over $22,000 for a family of four).  While acknowledging the extent of the hardships facing millions of Americans families, the White House emphasized the important role that increases in unemployment insurance benefits and Social Security payments that were part of the 2009 Recovery Act played in keeping millions of Americans out of poverty – indeed, the poverty rate for seniors actually declined this past year.  Meanwhile, the Center on Budget and Policy Priorities noted that if low-income tax credits and non-cash benefit programs, such as food stamps, had been included, the rise in the poverty rate would have been considerably smaller.  (A new Supplemental Poverty Measure, which we discussed in this recent post, will include these benefits).

The national health insurance data showed a continuation and acceleration of long-term trends: an overall decline in the percentage of Americans with health insurance, with progress in increasing the ranks of insured children through expanded access to public insurance (Medicaid and CHIP) being more than offset by the erosion of employer-sponsored insurance, leading to growing numbers of uninsured adults. Overall, the number of Americans without health insurance increased by 4.3 million to 50.7 million, bringing the rate of uninsured to 16.7 percent. Read the rest of this entry »

This is the fourth in an ongoing series of posts looking at the impact of the new federal health care reform law on Oklahoma and Oklahomans. Our previous posts have explored the “cliff effect” , the  impact on state budgets and the Temporary High Risk Pool. For full information on health care reform, the Henry J. Kaiser Family Foundation website is excellent. If you have thoughts on health care reform, we encourage you to contribute a comment or a guest blog.

Most people who have been following the Affordable Care Act, the new health care law passed earlier this year, know that the law will strengthen the individual market for health insurance coverage, by offering subsidized coverage on the new health insurance exchanges, and expand access to public coverage for low-income families through Medicaid. What is less well known and understand is that the Affordable Care Act also includes several important mechanisms for strengthening the beleagured employer-based system of health insurance coverage, especially for small businesses that currently face the greatest challenges in offering coverage to their workers and where the rates of the uninsured are currently the highest.

A recent report from Families USA looks at one of the most important provisions of the new law, tax credits for small businesses that will provide significant help with the cost of coverage. Beginning this year, businesses with fewer than 25 workers and average wages of less than $50,000 will be eligible to receive a tax credit for the health insurance premiums they provide to their employees.  The smallest firms with the lowest wages will be eligible for the maximum credit, which is 35 percent of the cost of coverage, or 25 percent for non-profits. The credit will phase down for businesses with more employees and higher average wages. Businesses that are already offering coverage, as well as those opting to cover the workers for the first time, will be eligible for the credits. After 2014, when the new health insurance exchanges will be operating, credits will increase to 50 percent of the cost of coverage, or 35 percent for non-profits. Read the rest of this entry »

A key provision of the health care reform law passed in March creates new insurance options for individuals with pre-existing health conditions. The new program, known as the Oklahoma Temporary High Risk Pool, began accepting applications this week. Click here for further information about eligibility and how to apply. Here is our blog post on the subject from May.

It’s a widely known and much lamented fact that our current health insurance system can place the greatest obstacles in the path of precisely those most in need of affordable and adequate coverage. Individuals with pre-existing medical conditions who are unable to obtain coverage through their employer or government programs tend to be left uninsured or paying exorbitant premiums for insurance that may exclude their chronic conditions or disabilities.

A central goal of the new health care reform law passed in February is to solve this problem by prohibiting insurance companies from denying coverage based on pre-existing medical conditions. This prohibition will apply both to employer-based coverage and to products offered through the new health insurance exchanges, where those not covered by employer or public insurance will be able to purchase coverage, with sliding scale subsidies available for those with income up to 400 percent of the federal poverty level. Read the rest of this entry »

This is the second of what will be an ongoing series of posts looking at the impact of the new federal health care reform law on Oklahoma and Oklahomans. The first looked at how reform will mitigate the public benefits “cliff effect”. For full information on health care reform, the Henry J. Kaiser Family Foundation website is excellent.We encourage your contributions as comments or as  a guest blog.

The passage of the new federal health care law represents a monumental shift in the nation’s health care delivery system that will unfold over the coming years. States and state governments will be effected by the new law in myriad ways, only some of which are recognized at this early stage. One issue that has caused some concern for state governments, particularly in the context of the deep and prolonged state fiscal crisis, is the obligation that states will eventually be asked to assume for a portion of the cost of covering the newly insured.

With the passage of health care reform, the Oklahoma Health Care Authority has estimated that an additional 250,000 Oklahomans will be newly qualified for Medicaid, the nation’s primary health insurance program for the poor, jointly financed by the federal and state governments.  Under the law, all working-age  adults with household incomes up to 133 percent of the federal poverty level – around $24,000 for a family of three in 2009 – will become eligible for Medicaid effective in 2014.  Read the rest of this entry »

This is the first of what will be an ongoing series of posts looking at the impact of the new federal health care reform law on Oklahoma and Oklahomans. For full information on health care reform, the Henry J. Kaiser Family Foundation website is excellent. We encourage your contributions as comments or as  a guest blog.

Last June, I posted a blog which I titled “Sorry, I can’t afford that raise” discussing the cliff effect. This is the situation  that occurs whereby low-income working families lose eligibility for public benefit and work support programs as their incomes rise.  As described in a 2007 report prepared for the Women’s Foundation of Colorado and the Women and Family Action Network Coalition:

A benefit cliff occurs when just a small increase in income leads to the complete termination of a benefit. The result is that parents can work and earn more, while their families end up worse off than they were before.

I noted that:

At a certain threshold, workers find themselves in a situation where the rational response to an offer of a raise or a better job is to respond, “Sorry, but I just can’t afford it.” Read the rest of this entry »