Oklahoma Is in a Tough Place When It Comes to Health (KWGS)

By Matt Trotter

First, some good news from Oklahoma Policy Institute Executive Director David Blatt on the state’s health rankings.

“Chlamydia, we’re only ranked 23rd, so you can maybe see that on a T-shirt someday soon: Oklahoma — only 23rd in rates of chlamydia!” Blatt said Wednesday during a presentation at Morton Comprehensive Health Services. “But for the rest of it, we’re really not doing so well.”

Oklahoma ranks 44th in overall health according to United Health Foundation. That includes bottom-10 rankings in heart disease, diabetes and infant mortality.

Many of these health indicators have racial disparities. For example, black babies are three times more likely to die before their first birthdays than white babies. And while eight in 10 Oklahomans overall say they can access healthcare when they need it, “when you break down access to healthcare, only seven in 10 African-Americans and Latinos report being able to get the healthcare they needed,” Blatt said.

Health insurance is the biggest factor in increasing access to healthcare. For 15 years, the state’s uninsured rate hasn’t changed. One in six Oklahomans is uninsured; another one in six is on Medicaid.

Policy changes in the 1990s led to almost half of Oklahoma’s children being on Medicaid today. Blatt said the Affordable Care Act was intended to reduce the large number of uninsured adults.

“The main mechanisms that the law intended to address a situation where 47 million Americans, 650,000 Oklahomans were uninsured was to provide subsidies for folks to buy individual coverage on the exchange and for low-income folks to get coverage through Medicaid,” Blatt said.

In the first year under the ACA, 15 percent of uninsured Oklahomans signed up — the seventh-lowest rate in the nation, even though 80 percent of enrollees received tax credits. Blatt said that’s not entirely surprising in Oklahoma’s political climate.

“State leadership has been uniformly negative or hostile to the Affordable Care Act,” he said. “There was very little cooperation from the state insurance department or other public agencies.”

Insurance Commissioner John Doak’s public treatment of the law may be softening, however, ahead of the next open enrollment period, which begins Nov. 15.

“In fact, he’s put out the last two press releases about the Affordable Care Act without even using the word ‘Obamacare’,” Blatt said.

Maybe because the exchanges are working. All of the insurers on Oklahoma’s exchange last year are returning, and a new one is joining. Competition has lowered or kept premiums even. Most importantly, the uninsured rate is down.

Blatt said Oklahoma could do better, though.

“All the top 10 states that have seen the largest drop have expanded Medicaid and are running their own exchanges. That combination has been really successful,” Blatt said.

In fact, the top two states aren’t all that different from Oklahoma.

“Arkansas and Kentucky are two states that look very much like Oklahoma if you look at the demographics, if you look at where we are in health indicators,” Blatt said. “But they have taken positive action to expand coverage while Oklahoma has said no.”

SoonerCare has been a success, but state leaders continue to oppose Medicaid expansion. The Oklahoma Health Care Authority received flat appropriations from the legislature for 2015, leaving it a 223 million dollar shortfall overall. And the state’s uncompensated care fund will get just one-fourth of what community health centers estimated they’ll need for 2015.

Blatt’s summary of healthcare in Oklahoma: At the intersection of rock and hard place.


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