Oklahoma’s Health Landscape Carly Putnam

Source: United Health Foundation, 2016 Overall Oklahoma Ranking: 45 Binge drinking6Salmonella44 Underemployment rate6Poor physical health days44 Pertussis22High blood pressure44 Low birthweight28Lack of health insurance44 Insufficient sleep29High cholesterol44 Air pollution34Heart attack44 Chlamydia37Preterm birth45 Dentists38Obesity45 Suicide38Cancer deaths45 Stroke39Drug deaths45 Violent crime39Occupational fatalities46 Poor mental health days39Premature death46 Children in poverty40Vegetables46 Smoking40Physical inactivity46 Infant mortality41Dental visit, annual48 Heart disease41Cardiovascular deaths48 Infectious disease42Teen birth rate48 Diabetes43Fruits49

Health Status: Heart disease Oklahoma ranked 7th nationwide for prevalence of heart disease & 2 nd for deaths per 100,000 due to heart disease in Heart disease is the leading cause of death in Oklahoma, accounting for 1 in 4 deaths in – 50 percent higher death rate for men than for women – Rates highest for African-, Native Americans Source: Kaiser Family Foundation; 2014 State of the State’s Health Report

Health status: infant morality Source: State of the State’s Health 2014

Health disparities: infant mortality Source: State of the State’s Health 2014

Health disparities: access to care Source: Kaiser Family Foundation

Source: Census Bureau Uninsured rate, 50 states, 2013 & 2014

Source: Census Bureau

Source: SoonerCare Fast Facts

The Affordable Care Act The ACA builds on the existing US health care system by strengthening and expanding the three pillars of health insurance coverage: – Employer-sponsored coverage – Public insurance – Individual coverage Two principle mechanisms for expanding coverage: – Premium tax credits – Medicaid expansion

The Affordable Care Act Insurance can be purchased on online marketplaces 145,000 Oklahomans enrolled on the marketplace 84% received premium assistance (tax credits) Level Monthly Premium CoPay or Out- of-Pocket Costs PlatinumHighestLowest GoldHighLow SilverMiddle BronzeLowHigh Source: Kaiser Family Foundation

Medicaid & The ACA States have the option to expand coverage to those earning below 133 percent FPL Federal government pays 100 percent of costs through 2016; scales back to and remains at 90 percent by 2020 & onward. Nineteen states are not moving forward at this time

The Coverage Crater 91,000 Source: Kaiser Family Foundation

Source: SAMHSA, NewsOK 25% ($53M) spent on inpatient psychiatric hospitalization 70% ($150M) spent on community-based care & services 5% ($11M) spent on prevention

Source: Census Bureau Uninsured rate, 50 states, 2013 & 2014

January 16: “Oklahoma mental health agency considers cutting private-practice counselors from SoonerCare” February 18: “More mental health funding is needed, parents tell Oklahoma lawmakers at forum” March 8: “Budget cuts will limit care options for Oklahoma's poor, uninsured” March 13: “State's budget crisis may incapacitate Medicaid program, officials say” March 25: “Thousands with mental illness will lose services in Oklahoma” March 29: “Oklahoma Medicaid agency proposes 25 percent provider rate cut”

Medicaid Rebalancing Act of 2020

Questions? For more information, see okpolicy.org/issues/healthcare Carly Putnam