Guest Blog (Julie Miller-Cribbs, MSW, PhD): Young and Uninsured in Oklahoma

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.

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.

Only a very small percentage of those without insurance reported that they did not have insurance because they did not need it. Further, those without insurance reported worrying about their health significantly more than those with insurance. Overwhelmingly, the main barrier for uninsurance status was cost: 85 percent of those survey indicated that cost was a significant barrier for obtaining health insurance. Many young adults also believed that they would not qualify for state insurance programs or were not employed, or employed at jobs without health coverage.

When those young adults without insurance were asked what they considered to be an affordable monthly premium, 97 percent reported that they could only afford a premium under $100.00.

Another assumption about young adults is that they are a fairly healthy group, with fewer and lower medical costs. Results from this study reveal a different picture. Young adults struggle significantly with medical costs; more troubling, 60 percent of uninsured young adults report having medical debt and 57 percent report that they have used pay day lenders to assist with covering medical costs. Debt among Oklahomans is a a major problem, and health care costs are a significant portion of this debt.

Further, young adults without insurance coverage report poorer health and over half report having long term and ongoing medical problems that require regular care as well as health related limitations.


Improving coverage for young adults is an important policy problem for Oklahoma, so what could be done?

  • Address the affordability of coverage.
  • Expand access to affordable care for Oklahoma’s young workforce. If we promote pathways to higher education and training for young adults, better paying jobs will mean better health insurance coverage.
  • Educate young adults about state programs. Many young adults believe they are not eligible or are aware of state programs designed for adults without health insurance (e.g. Insure Oklahoma).
  • Consider marketing campaigns aimed at young adults. On the precipice of health reform in Oklahoma and the development of health exchanges, young adults will require information specific to their needs. Social media campaigns that explain health care changes and options will increase knowledge and enhance decision making. Targeting young adults who are particularly at risk for underinsurance is also important (e.g. those without access to Cobra coverage through parents, lower income or minority young adults).

Strategies such as the above could prevent some of the serious health and financial consequences that young Oklahomans experience without health insurance coverage. Secure coverage would afford them both health and future economic stability.

This blog summarizes some findings of a collaborative state-wide survey of young, uninsured Oklahomans by the University of Oklahoma–Anne and Henry Zarrow School of Social Work and the Oklahoma Insurance Department. For the full report, please contact

The opinions stated above are not necessarily those of OK Policy, its staff, or its board. This blog is a venue to help promote the discussion of ideas from various points of view, and we invite your comments and contributions. To see our guidelines for blog submissions, click here.




The opinions stated in guest articles are not necessarily those of OK Policy, its staff, or its board. To see our guidelines for blog submissions, click here.

4 thoughts on “Guest Blog (Julie Miller-Cribbs, MSW, PhD): Young and Uninsured in Oklahoma

  1. The lack of insurance coverage for young adults has a significant impact upon their family members. Parents often struggle to pay for uninsured young adults’ health care needs, adding to our own financial burden.

    Since 19-34-year-olds are in their peak childbearing years, lack of health coverage prevents them from obtaining both contraception and pre-conception health services. This increases public expenditures for unintended pregnancies, and puts mothers and their infants at risk for health complications that could have been avoided with routine medical care (e.g., problems stemming from infections such as beta strep, which is a common cause of premature births; toxoplasmosis, which causes severe fetal damage; rubella, which can cause loss of hearing; and sexually transmitted diseases, which can have a range of deleterious effects on parents and their unborn children).

    Uninsured young adults add to the burden on our emergency departments as they seek care for problems that could be handled better and more cheaply in a doctor’s office or clinic.

    Young adults who suffer from mental illness are further at risk. A year ago my daughter lost a former roommate to suicide as a result of untreated bipolar disorder. Many young people also wrestle with substance abuse, and Oklahoma has only a fraction of the beds or treatment slots needed to address our burgeoning addiction problems.

    Without adequate health coverage for all citizens, Oklahomans suffer and we all pay the consequences.

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