OKPOLICY.ORG
Fifteen years after Oklahoma expanded Medicaid eligibility for children, the number of uninsured children in the state continues to fall. The child uninsured rate in Oklahoma reached an historic low of 8 percent in 2011-2012, which is half the rate (16 percent) of 1999-2000, according to new Census Bureau data released today. There are 53,000 fewer uninsured children now in Oklahoma than there were in 1999-2000, even as the state’s overall child population has grown by some 80,000.
The state’s success in reducing the uninsured rate for children stands in stark contrast to the situation for working-age adults, 24 percent of whom were uninsured in 2011-12, up from 21 percent in 1999-2000. The persistence of a high uninsured rate for working-age adults underscores the importance of the Affordable Care Act, which will make affordable coverage available to working-age adults above the poverty line through the new insurance marketplaces, and could also cover adults below the poverty line if Oklahoma accepts federal funds to expand coverage.
Overall, just over 1 in 6 of all Oklahomans (17.1 percent), or 638,000 people, were uninsured during the most recent two-year period of 2011-12, which is essentially unchanged from 2010-11 (17.0 percent) . Oklahoma’s uninsured rate remains above above the national average, which fell from 15.7 percent in 2011 to 15.4 percent in 2012.
Compared to twelve years ago, private insurance coverage — in particular, employer-provided coverage — has declined significantly in Oklahoma. Just 52 percent of all Oklahomans now receive health insurance through an employer, compared to 57 percent in 1999-2000. This decline applies to both children under 18 (56 percent in 1999-2000 to 47 percent in 2011-2012) and working-age adults (61 percent in 1999-2000 to 54 percent in 2011-2012).
The biggest contrast between children and adults has been the availability of Medicaid to fill more of the gap resulting from declining private coverage. Forty-five percent of children under 18 in Oklahoma are now covered by Medicaid, compared to only 20 percent from 1999-2000. Since implementation of the Children’s Health Insurance Program (CHIP) in 1997, children in families with income up to 185 percent of the federal poverty level have been eligible for SoonerCare, the state’s Medicaid program. Among working-age adults, only 7 percent were covered by Medicaid in 2011-2012. Soonercare covers only pregnant women and parents of dependent children with income below 37 percent of the federal poverty line. The Census Bureau report found 401,000 Oklahoma children were covered by Medicaid in 2011-2012, compared to just 141,000 working-age adults.
Oklahoma and other states’s success in tackling the problem of uninsured children may soon be replicated for adults as the Affordable Care Act approaches full implementation. Starting October 1st, Oklahomans who can’t get affordable health insurance through their jobs but earn too much to qualify for Medicaid can sign up for coverage for 2014 through the state’s new health insurance Marketplace. Many people will be eligible for new tax credits to help pay premiums and reduce out-of-pocket health care costs. Some 337,000 Oklahomans will be eligible for these tax credits, according to a Families USA study.
However, Oklahoma’s leaders continue to refuse to accept federal Medicaid funds to cover up to 230,000 adults with income below the poverty line, even though a report requested by Governor Fallin found that extending coverage would provide a large economic boost to the state and would lead to substantial net savings for the state budget. Continued refusal to accept federal funds leaves this lowest-income population, most of whom are are employed, in a “coverage crater”, with no way to get health insurance.
