Oklahoma’s progress on child uninsured rate has stalled

All children should be able to see a doctor or fill a prescription when they need to. After all, access to quality health care in childhood makes it more likely that a person will succeed and thrive throughout their life. But in Oklahoma, children are less likely to have access to health care than their peers in most other states. New analysis of Census Bureau data shows that after years of steady declines in the child uninsured rate, progress in Oklahoma has stalled: for the last three years, the child uninsured rate has hovered at around 8 percent. In 2017, that gave us the fourth-highest share of children without health insurance in the US, working out to 82,000 children uninsured. That’s enough to nearly fill OU’s Gaylord Family Oklahoma Memorial Stadium (capacity: 86,112). 

This is bad news for Oklahoma – but fortunately, Oklahoma has the opportunity to remedy the problem. Bringing access to quality, affordable health care to our children will protect their health, position them to seize the opportunities offered in school and at work, and set Oklahoma on the path to being a better, stronger state.


Refusing to expand Medicaid has hurt Oklahoma

The Affordable Care Act gave Oklahoma the opportunity to expand access to health care for thousands of low-income adults through their Medicaid programs. For five years now, the state has refused to do so, leaving thousands of people with little access to consistent health care and saddling hospitals and other care providers with high rates of uncompensated care. However, the effects extend to children, too. When adults get access to health coverage, they’re more likely to get their children enrolled, too – even if their children were already eligible for coverage.

Unfortunately, the reverse is also true: when parents don’t have health coverage, their children are more likely to go uninsured. Of the 25 states with the highest uninsured rate, 16 hadn’t expanded Medicaid in 2017. By contrast, of the 25 states and Washington, D.C. with the lowest uninsured rates, 23 had expanded access to coverage (several states have since chosen to expand, although those expansions haven’t yet taken effect). Oklahoma’s child uninsured rate is among the highest of our neighboring states, outpaced by only Texas – which has the highest child uninsured rate in the country. 

Access to health coverage increases access to prosperity

The issues created when children go uninsured are obvious. Uninsured children are more likely than their insured peers to have unmet health care needs and to lack a usual source of care. Furthermore, children’s coverage through Medicaid is particularly robust, with a battery of services and options not available for adults, from eyeglasses and dental services to more complex screenings and therapies. 

However, Medicaid’s benefits extend beyond access to health care. With treatment for medical conditions like asthma and diabetes, children are less likely to miss school, score better on state tests, and are better able to get the most out of their education, setting them up for success later in life. Indeed, children with access to Medicaid are less likely to drop out of high school and more likely to enter and graduate college. Childhood Medicaid even increases earnings for adults. And because Medicaid is comprehensive health insurance with limited cost sharing, Medicaid reduces financial hardship for families, effectively shielding children from some of the trauma of childhood poverty. 

Unfortunately, Oklahoma hasn’t just refused to expand Medicaid; it has also limited or rolled back other coverage as well, with consequences for whole families. Last spring, Oklahoma passed a bill instructing the state Medicaid agency to build a plan to cut health coverage for low-income parents who don’t meet a work requirement, despite ample evidence that such measures do far more harm than good. Oklahoma has also consistently refused to promote or encourage enrolling in health coverage during Open Enrollment, even though more than one-quarter of Oklahoma’s uninsured are likely eligible for tax credits. 

Increasing access to health coverage for children would make Oklahoma a stronger state 

The economic and social benefits of robust health coverage are clear. However, across much of the US, child uninsured rates are ticking up, reversing a decade of progress. New, extreme changes to federal immigration policy may exacerbate the problem, scaring immigrant families away from needed health care, and the federal government appears unlikely to back away from its opposition to quality health coverage in favor of flimsier, junk insurance. But Oklahoma can take steps to address the problem, allowing more families the freedom to thrive with the security that health coverage brings. Expanding Medicaid, promoting enrollment in marketplace coverage, and reversing damaging attempts to roll back coverage would go a long way toward making Oklahoma a better state not just for businesses and workers, but for families, too.  

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Carly Putnam joined OK Policy in 2013. As Policy Director, she supervises policy research and strategy. She previously worked as an OK Policy intern, and she was OK Policy's health care policy analyst through July 2020. She graduated from the University of Tulsa in 2013. As a student, she was a participant in the National Education for Women (N.E.W.) Leadership Institute and interned with Planned Parenthood. Carly is a graduate of the Oklahoma Center for Nonprofits Nonprofit Management Certification; the Oklahoma Developmental Disabilities Council’s Partners in Policymaking; The Mine, a social entrepreneurship fellowship in Tulsa; and Leadership Tulsa Class 62. She currently serves on the boards of Restore Hope Ministries and The Arc of Oklahoma. In her free time, she enjoys reading, cooking, and doing battle with her hundred year-old house.

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