Camille Landry is a writer, activist, and social justice advocate who lives in Oklahoma City. This post is part of our “Neglected Oklahoma” series, which tells the stories of Oklahomans in situations where the basic necessities of life are hard to come by. These are real people and their stories are true (names have been changed to protect privacy).
The state budget crisis has legislators thinking the unthinkable in an effort to balance the state’s books. One such proposal would eliminate SoonerCare coverage for “able-bodied adults.” Over 111,000 Oklahomans would lose SoonerCare benefits if Rep. Doug Cox’s (R-Grove) HB 2665 succeeds in eliminating Medicaid benefits for non-pregnant able-bodied adults younger than 65. If signed into law, the measure would go before federal regulators, who are unlikely to approve it. However, it’s important to consider the Oklahomans this measure would affect and what it means that a bill that would kick them off their health insurance successfully passed through the state House [UPDATE: HB 2665 was defeated in the Senate Health and Human Services committee on March 29th]
Jannae Coltrane lives outside of Noble. She has a 4-year-old daughter with Down Syndrome and multiple associated medical disorders. Jannae used to take her daughter to a licensed daycare provider who had the training and experience to properly care for medically fragile children. The provider went out of business and there isn’t another daycare center in her town who can adequately care for her child. Jannae had to choose between keeping her job or risking her child’s health and safety. On weekend nights, Jannae leaves her daughter with her mom and earns $8/hour to watch over an elderly gentleman. This nets her $128/week.
Jannae is enrolled in Oklahoma’s Medicaid program, SoonerCare, as the low-income parent of a dependent child. Her income puts her well under the annual income cap for adult SoonerCare participation. SoonerCare benefits are granted for six-month periods, renewable for an additional 12 months based on income criteria.
SoonerCare pays for some – but definitely not all – of Jannae’s medical care. She has copays and a limit on the number of prescriptions she can get each month. Vision and dental care are not included. In the last year SoonerCare covered a case of strep throat, hypertension exams and medications, her annual wellness checks, and treatment for the back strain she got from carrying her growing daughter. “At least I know I can get to a doctor if I need one,” Jannae said.
Kyle Leavitt and his two sons moved to Lawton when his elderly grandparents sold the family farm near Madill that he used to work on. Kyle worked for a year as a construction laborer in and around Ardmore – jobs that pay reasonably well but are sporadic. A car wreck caused leg and back injuries that have made it difficult for him to work. Now Kyle works a few hours a week at a retail store. He and his kids share a duplex with his sister and niece. His total income last year was well under $10,000. Kyle is now insured by SoonerCare, as are his sons.
“I got bit by a brown recluse spider and it got infected,” he said. “I was looking at over $8,000 in medical costs just for a bug bite and I couldn’t afford to get the antibiotics or wound care I needed.” The hospital helped him enroll in SoonerCare, which picked up the costs for his treatment. Kyle showed me the indentation in his leg where doctors cut away necrotic tissue from the infection. “I could have lost my leg if I didn’t have that insurance,” he said.
Healthy adult SoonerCare recipients do not have employer-sponsored health insurance and make too little money to qualify for subsidies under the Affordable Care Act or the state’s Insure Oklahoma program. The risks of living without medical coverage are well known. They include millions of dollars in unpaid bills to hospital emergency departments and other medical providers – a financial burden to health providers that results in higher costs to all consumers and a catastrophic fiscal burden to all health providers, particularly those in rural areas.
“I never, ever intended to be in this position. Before my daughter got really sick, I was enrolled in the Technology Center’s network engineering program. I was headed for good-paying, stable career. Now I can’t go to school, can’t work, and if I get sick, I guess I’m just toast.”
This situation causes substantial human and economic cost for the state, says the Oklahoma Hospital Association. Rural hospitals are particularly vulnerable. Pauls Valley Hospital declared bankruptcy and Sayre Memorial Hospital closed its doors as a result of revenue shortfalls. Many other hospitals are struggling to remain open.
Most uninsured people go for long periods of time without adequate medical care. Lack of access to preventive care and chronic disease treatment increases the severity of symptoms and often results in higher costs for critical care. Problems that are easily manageable by primary physicians turn into emergencies or serious illnesses, which result in premature death for about 38 Oklahomans every month.
The U.S. Census reports that 498,386 working-age Oklahomans lacked medical coverage in 2014. That’s more than one of of every five Oklahomans age 18 to 64.
“I never, ever intended to be in this position, Jannae said. “Before my daughter got really sick, I was enrolled in the Technology Center’s network engineering program. I was headed for good-paying, stable career. Now I can’t go to school, can’t work, and if I get sick, I guess I’m just toast.”
Kyle is considering sending his kids back to live with their mom, even though he feels they are better off with him. “I’ve trying to save up enough to move to Dallas or anyplace I can find a steady job,” he said. “I want to work. I hate having to depend on the government and my family for help. I feel like almost anyplace would be better than here, but right now, I got nothing.”
UPDATE: Since our interview, Kyle has been hired for part-time jobs at a local hardware store and with a landscaping company. He no longer receives SoonerCare and his child care and SNAP benefits have been cut. His part-time status means he is not eligible for employer-sponsored health insurance. He’s hoping to work his way into a full-time position with benefits.