Working poor could get health insurance under plan

Monday, January 26th 2004, 12:00 am
By: News On 6

OKLAHOMA CITY (AP) _ Most months Janie Barrios tries to decide which bills her family will pay and which ones will go unpaid until next month.

The 23-year-old woman and her husband don't have the money to add a health insurance premium to their stack of payments.

Like nearly a quarter of Oklahomans, Barrios is without medical insurance. Oklahoma lawmakers will look for ways to expand health coverage in the state in the legislative session that begins Feb. 2.

``It's something I've been thinking about a lot,'' said Barrios, who makes money by tinting windows for about $35 a car. ``But when I get a paycheck and pay off this person I owe $10, and another person I owe, you look at your pocket and there's nothing really left for you.''

In a good week working at the auto tint shop, she and her husband make $500 to $600 to support themselves and their 6-year-old daughter. In the winter, work is sporadic and they are lucky to work at all.

Oklahoma ties with California for fourth in the percentage of population with no medical benefits, according to a Kaiser Family Foundation study.

Under a plan proposed by Gov. Brad Henry, some of the state's uninsured would be covered by a health insurance plan supported by state and federal money and employer and employee contributions.

Henry will ask lawmakers this session to consider a tax on cigarettes to pay for the health insurance program. A similar proposal for a cigarette tax died in the last legislative session.

``Everybody has a stake in the system. People who have insurance are paying more to cover the cost of people without insurance,'' said Henry's spokesman Paul Sund. ``It's in the state's best interest to try to get insurance coverage for as many people as possible.''

About 17 percent of Oklahoma's uninsured are children. More women than men are without health insurance in Oklahoma, but only by a small margin, the Kaiser foundation study shows.

Low-income pregnant women and children are eligible for Medicaid. People over 65 are covered by Medicare.

The rest, mostly people between the ages of 18 and 64, are on their own.

About 41 percent of the uninsured in Oklahoma, are part-time or seasonal workers and more than half make less than $14,128 a year, according to data compiled by the Kaiser foundation.

Barrios' boss has offered to help her buy into the same private plan his family has. Barrios' daughter recently dislocated her arm and it's not clear whether new coverage would pay for this problem.

``Even if they just pay a portion, that's something,'' said Barrios, who had insurance coverage for the first time in her life when she got Medicaid during her pregnancy.

Barrios has applied for Medicaid for the child, but the application is pending.

Oklahoma's proposed plan would capture about 200,000 of the nearly 650,000 people without health insurance in Oklahoma, Secretary of Health Tom Adelson.

The New Mexico legislature has approved a similar plan that would use a combination of state, federal and employer-employee contributions to help people get health insurance.

New Mexico is still working out ways to finance its plan, and is expected to begin enrolling people this summer, said Betina McCracken, director of communications for the New Mexico Department of Human Services.

Other states like Illinois and Oregon have shifted federal and state funds to include more adults in the public health care system.

The proposed Oklahoma plan also would allow people to buy into the Medicaid program by paying a health insurance premium on a sliding scale based on their income.

``The state just doesn't have the resources to cover all the 650,000 of the uninsured,'' Adelson said. ``We really do value hard work and want to help people who have access to health insurance get it through their employer.''

To improve health care access for needy families, the plan also calls for an increase in the reimbursement rates for doctors who provide care to Medicaid patients.

``A lot of times people who are uninsured or publicly insured can't get a doctor to see them,'' said Adelson. ``They have been underserved and we would like increase the panels of providers.''

A tax on health care providers' total revenue is also being proposed to improve access to care and give money back to health care providers.

Money from the tax would be doled out to doctors who see people with Medicaid and would improve the reimbursement rate that otherwise makes those patients unattractive.

``Oklahoma's health care system must serve all Oklahomans, including a third of whom they provide care to at a loss,'' Adelson said. ``Those providing care, are providing it at a lower cost and the privately insured are picking up the cost.''