When they rejected federal government money to help set up a health-exchange system here, Gov. Mary Fallin and other Republican leaders eliminated the political risk of alienating the GOP base angry over “Obamacare,” but their action could represent a huge missed opportunity to help thousands of Oklahomans receive better medical care.
Fallin initially supported the idea of the $54.6 million grant, but then she flipped on the issue. According to one health writer, “It is by far the largest health reform grant that any state has rejected.”
Fallin has opposed the Affordable Care Act and supports the state’s lawsuit against it, but her initial argument about the grant was Oklahoma needed to be ready to set up the exchange system as required by law if it wasn’t eventually appealed. This was sound thinking, even if it seemed to contradict her adamant stance against the ACA.
Health care exchanges allow people to pool together to buy health insurance at cheaper rates.
Now, the state will use its own money and private dollars to fund the initiative, according to Fallin, but with Oklahoma facing at least a $500 million budget shortfall-some legislators are now arguing it will be even more-the money will be difficult to find. And how will private dollars politicize the nature of the system here?
Perhaps an even larger problem is whether Oklahoma, without federal assistance, can produce an efficient system. The state’s track record on health-care issues and medical outcomes is absolutely dismal. To ignore this fact is to deny the historical record and to doom the state to more mediocrity when it comes to health care.
Let’s look at some of Oklahoma’s health care statistics, released before the vote on ACA:
Roughly 1.9 million people in Oklahoma get health insurance on the job, where family premiums average $12,256, about the annual earning of a full-time minimum wage job.
Since 2000 alone, average family premiums have increased by 77 percent in Oklahoma.
Household budgets are strained by high costs: 29 percent of middle-income Oklahoma families spend more than 10 percent of their income on health care.
High costs block access to care: 17 percent of people in Oklahoma report not visiting a doctor due to high costs.
Oklahoma businesses and families shoulder a hidden health tax of roughly $1,900 per year on premiums as a direct result of subsidizing the costs of the uninsured.
19 percent of people in Oklahoma are uninsured, and 70 percent of them are in families with at least one full-time worker.
The percent of Oklahomans with employer coverage is declining: 54 percent were covered in 2007.
While small businesses make up 78 percent of Oklahoma businesses, only 39 percent of them offered health coverage benefits in 2006.
Choice of health insurance is limited in Oklahoma. BCBS OK alone constitutes 45 percent of the health insurance market share in Oklahoma, with the top two insurance providers accounting for 71 percent.
Choice is even more limited for people with pre-existing conditions. In Oklahoma, premiums can vary based on demographic factors and health status, and coverage can exclude pre-existing conditions or even be denied completely.
The overall quality of care in Oklahoma is rated as “Weak.”
16 percent of children in Oklahoma are obese.
28 percent of women over the age of 50 in Oklahoma have not received a mammogram in the past two years.
45 percent of men over the age of 50 in Oklahoma have never had a colorectal cancer screening.
76 percent of adults over the age of 65 in Oklahoma have received a flu vaccine in the past year.
To her credit, Fallin is staying ideological consistent. She campaigned for governor on an anti-President Barack Obama theme and the ACA is the president’s signature legislation. She won by a landslide. By rejecting the money, the governor will solidify the support of the most extreme elements in her party behind her, but at what cost to the general health to the state’s residents?