For years, we’ve advocated expanding access to health coverage for low-income adults in Oklahoma. More than 30 states have done so, and in the process have dropped their uninsured rates, increased access to needed care, and pulled rural hospitals onto better footing. However, this year Oklahoma legislators seem determined to move in the opposite direction, pushing for radical new restrictions to the state’s basic health coverage program for low-income adults. That’s exactly the wrong thing to do. Here’s why.
Very few SoonerCare members are working-age adults
Most people who rely on SoonerCare, Oklahoma’s Medicaid program, for their health care are children, people with significant disabilities, or the elderly. Less than 10 percent of SoonerCare members are working-age adults, all of whom are parents; childless adults without disability determinations can’t qualify for Medicaid in Oklahoma.
And these parents have to be very, very low income to qualify. A single mother with two children can’t earn more than about $800 per month in order to qualify – just 46 percent of the federal poverty level, or what researchers refer to as “deep poverty.” A bill introduced this spring, SB 1030 by Sen. Brecheen (R-Coalgate) would slash the maximum income allowed by more than half, to just 20 percent of the federal poverty level. More than 43,000 parents would lose their health coverage as a result, 2 in 3 of whom are mothers. By cutting off access to health coverage, SB 1030 would threaten the financial stability of Oklahoma families’ and make it harder for those with chronic health conditions, like asthma or diabetes, to find and keep a job.
“Terminating parents’ health coverage won’t move them into jobs in any significant number. Instead, it’ll just make it more likely that they lose their coverage, can’t afford to see a doctor or fill a prescription, and ultimately become less healthy – and therefore less employable – as a result.”
SoonerCare provides needed, temporary support for working families
SoonerCare is designed to help low-income Oklahomans afford medical care when they fall on hard times. And data shows that this is exactly how SoonerCare works for low-income parents. On average, parents get their health coverage through SoonerCare for less than a year at a time, according to the Oklahoma Health Care Authority. This indicates that our safety net health care system is working as it was intended.
It’s also important to note that most adults on Medicaid who can work, do work. In Oklahoma, 8 in 10 adults on SoonerCare are in households where at least one adult is working or worked within the last six months. However, Oklahoma is in the process of instituting a work requirement for SoonerCare, which will mean the state will terminate health coverage for parents who don’t work enough hours. This jeopardizes health care access for all parents in this category, including those who are working: many low-wage workers don’t have control over what (or how many) hours they work. And requiring low-income parents to jump through more bureaucratic hoops to keep their coverage or prove they qualify for an exemption will result in coverage losses even for people who should be eligible.
Work requirements won’t be effective for parents who aren’t working, either, because a work requirement doesn’t actually address these parents’ barriers to work. Nearly 4 in 10 nonworking adults on Medicaid have an illness or disability that impedes their ability to work, and 1 in 3 are taking care of a child, an aging parent, or a sibling with a disability. Until those needs are met, terminating their health coverage won’t move them into jobs in any significant number. Instead, it’ll just make it more likely that they lose their coverage, can’t afford to see a doctor or fill a prescription, and ultimately become less healthy – and therefore less employable – as a result.
Child health coverage is closely tied to parent health coverage
More children in America have health coverage than ever before, and it’s because of the Affordable Care Act – even though the health law’s most significant changes were in access to care for adults. Prior to the ACA, many uninsured children were eligible for coverage, but their parents often didn’t know until they went to sign up for coverage themselves.
Similarly, when parents lose coverage, their children are less likely to keep their own health coverage, even if they still qualify. Access to health care in early childhood pays dividends throughout a child’s life. If Oklahoma wants to make sure its children are best equipped to grow and learn at their full potential, we should be eliminating barriers to health coverage for parents – not making more.
The bottom line
SoonerCare provides necessary medical care to qualifying parents when they need it. Oklahoma’s nonelderly uninsured rate is already one of the highest in the country, putting even more pressure on the state’s community health centers, hospitals, and other providers. Our state’s budget crises aren’t the fault of a few thousand low-income parents working to make better lives for their families, and lawmakers should stop seeking savings by cutting their health care.