Report: Affordable Care Act to substantially expand coverage, reduce uncompensated care in Oklahoma

The Affordable Care Act, the federal health care law that takes full effect in 2014, is expected to provide health insurance coverage to over 335,000 uninsured Oklahomans and reduce the state’s uncompensated health care costs by more than two-thirds , according to a new report from the Robert Wood Johnson Foundation (RWJF).

Currently, some 597,000 Oklahomans, or 19 percent of the non-elderly population, lack health insurance. Under the Affordable Care Act (ACA), the number of uninsured is projected to fall by 57 percent to 259,000, or 10 percent of the non-elderly population. Oklahoma’s 57 percent drop exceeds the national average of 48 percent and is the tenth highest drop among the states.

The researchers, who are health care policy experts at the Urban Institute, use the Health Insurance Policy Simulation Model to build projections of how coverage will be affected by the new law. For Oklahoma and for the nation, they find that the ACA will lead to more people with both public and private health insurance. Specifically, they project that:

  • An additional 202,000 Oklahomans will be covered by Medicaid. Of this population, 17 percent, or 36,000 people, are currently eligible but unenrolled for Medicaid, while the remaining 83 percent will be newly eligible as a result of the expansion of Medicaid eligibility to 138 percent of the federal poverty level for adults. These numbers further refute an alarmist study put out last year by the Oklahoma Council of Public Affairs which projected huge new costs for Oklahoma under the ACA based on four times as many currently eligible but unenrolled people signing up for Medicaid.
  • An additional 135,000 Oklahomans will be covered through private insurance, either through their employer or in the non-group market. The study projects an increase of 77,000 people covered through their employers and an additional 58,000 people covered in the non-group market.
  • Of the 2.0 million Oklahomans who will have private coverage after the law takes effect, some 275,000 are expected to purchase coverage through the new health insurance exchanges that will operate beginning in 2014. Of this population, some 100,000 are expected to be eligible for premium subsidies to assist with the cost of care.

The study also projects that the ACA’s coverage expansion will significantly reduce the amount of uncompensated care provided by Oklahoma hospitals, doctors, and other health care professionals and facilities. Uncompensated care costs are projected to fall by over two-thirds, 69 percent, from $886 million annually to $277 million.  Nationally, uncompensated care costs are projected to fall by 51 percent.

The study notes that Oklahoma, like several of the states that stand to see the greatest benefit from the Affordable Care Act, has made little progress towards implementing the new law. According to the study, Oklahoma is among 15 states that has not yet implemented a health insurance exchange or demonstrated significant interest in doing so, and one of only six states to have taken no legislative action in 2011.  The federal government will run the exchange in states that are not ready to launch a state-based exchange by January 2014, . Whether Oklahoma still can or should develop an exchange is certain to be a hotly contested issue during the 2012 legislative session. Yet unless the entire law is struck down (a question we will address in a forthcoming post), this report provides further grounds for confidence that the state’s long-standing problems associated with high rates of uninsured and uncompensated care should be significantly eased in the years ahead.

Click here to see the study, “State Progress Toward Health Reform Implementation: Slower Moving States Have Much to Gain”


Former Executive Director David Blatt joined OK Policy in 2008 and served as its Executive Director from 2010 to 2019. He previously served as Director of Public Policy for Community Action Project of Tulsa County and as a budget analyst for the Oklahoma State Senate. He has a Ph.D. in political science from Cornell University and a B.A. from the University of Alberta. David has been selected as Political Scientist of the Year by the Oklahoma Political Science Association, Local Social Justice Champion by the Dan Allen Center for Social Justice, and Public Citizen of the Year by the National Association of Social Workers.

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