Oklahoma’s refusal of federal dollars especially hurts African-American and Hispanic families

Drew Capps interned with OK Policy this spring and recently graduated from the University of Tulsa.

We’ve discussed previously, and at length, why Governor Fallin’s decision to reject federal funds to expand health coverage to low-income Oklahomans is the wrong move, especially when research shows that Medicaid expansion in other states has proven a good deal. Now, new analysis from Families USA lays out more of what Oklahoma gave up by not expanding coverage. Without the expansion, black and Hispanic Oklahomans are more likely to become ill from and die of chronic disease — and are also less likely to have insurance.

The data

Families USA’s analysis focuses on differences between people with and without health insurance with respect to three key health indicators:

• ability to afford visits to a doctor;
• having a regular doctor;
• going to routine check-ups.

Measured by these health indicators, the report finds that those without health insurance are notably worse off than those with health insurance in Oklahoma, particularly among Hispanics and African-Americans. Families USA finds 62 percent of uninsured low-income African Americans reported being unable to afford visits to a doctor, versus 23 percent of insured low-income African Americans; the same percentage reported no routine checkups. Fifty-five percent of the state’s low-income African-American women over the age 40 reported that they had not received a mammogram in the past two years, nearly double the rate of those with insurance.

Similarly, 39 percent of uninsured, low-income Hispanics reported being unable to afford visiting a doctor, versus 20 percent of insured, low-income Hispanics, and 76 percent of low-income, uninsured Hispanics reported not having a regular doctor, versus just 23 percent reported among low-income Hispanics with insurance.

Why it matters

Hispanic and black Oklahomans are more likely than their white counterparts to be diagnosed with chronic diseases – and also more likely to die of those diseases. Two-thirds of white adults in Oklahoma are overweight or obese, compared to 72 percent of black Oklahomans and almost 75 percent of Hispanic Oklahomans. Black adults in Oklahoma are more likely to have asthma than white adults in Oklahoma, and both African-American and Hispanic adults are more likely to report poor mental health. More black Oklahomans also die of diabetes and heart disease than white Oklahomans, and Hispanics are 50 percent more likely to die of liver disease nationwide. Early intervention can help prevent some chronic diseases and reduce the impact of others – but that require access to medical care that is often denied to low-income people of color in the state. 

Access to health care is important not only for lives and health, but also for building economic opportunity. Helping low-income Oklahomans to see a doctor and get routine checkups is one component of closing the opportunity gap. Healthy families are essential for building a well-educated, employable workforce – but when Hispanic and African-American Oklahomans are disproportionately uninsured, their education and employment are is disproportionately jeopardized, in turn perpetuating the racial wealth gap.

Having health insurance also means it’s less likely that a medical emergency – like a cancer diagnosis or a broken leg– will wipe out a family’s finances. The racial wealth gap already means that it’s that much harder for African-American and Hispanic Oklahomans to get ahead. Access to affordable health care would help nudge the playing field closer to level, and allow families to better weather income disruptions and unexpected expenses, and to save for college.

Oklahoma does a good job providing health coverage to low-income children, but their parents are often left without coverage. When health problems prevent those parents from getting and keeping a job, that hurts the children, too.

The bottom line

Oklahoma has prospered in recent years, but too many of our residents – particularly those who are black or Hispanic – are still locked out of that prosperity. This has very real and tragic cost. Expanding access to health coverage for low-income Oklahomans would create better health outcomes and help close the opportunity gap.