State leaders working on a plan to get Oklahomans insured

Lee Hill relies on a network of friends to help her when she's sick. The 58-year-old self-employed manicurist has been without health insurance for the last 12 years. <br><br>Her clients, some who

Saturday, December 20th 2003, 12:00 am

By: News On 6

Lee Hill relies on a network of friends to help her when she's sick. The 58-year-old self-employed manicurist has been without health insurance for the last 12 years.

Her clients, some who work in medical profession, diagnosis her ailments or provide prescription drug samples when she needs them.

Hill, a single woman who exercises and eats well, makes between $25,000 to $30,000 a year and can't afford to get sick.

``Without health insurance, I feel like its my job to stay healthy,'' she said.

Hill is one of 650,000 Oklahomans who aren't covered by private health insurance and don't qualify for Medicaid.

For Hill paying $300 to $400 a month for private insurance is unrealistic.

``It's always something that's on my mind. I always think, I'll do it next month, but then the engine blows out of my car or something, and I can't go without paying my rent,'' Hill said. ``I don't take vacations because, I think if I can afford to do that I should be able to afford health insurance. ``

Getting federal waivers to expand services offered by Medicaid may be at the top of the list for lawmakers next session and welcome news for people like Hill.

Oklahoma is one of 18 states where people without health insurance make up more than 16 percent of its population. The Oklahoma Health Care Authority estimates that nearly 18 percent of adult Oklahomans are without some type of medical coverage.

Minnesota, Rhode Island and Wisconsin have the lowest percentage of uninsured with 9 percent. Texas and New Mexico are the highest with 26 percent, according to a report issued this year by the Kaiser Commission on Medicaid and the Uninsured.

Under the current Medicaid program in Oklahoma, only low income pregnant women and their children and the disabled are eligible for coverage. Low-income people who are 65 and older are covered under Medicare, a similar program specifically designed for older people.

``My generation has been sort of lost in the shuffle,'' Hill said. ``We're past the childbearing age, but we're not old enough to get Medicare. We're the lost generation and we can't get any help.''

State lawmakers are researching ways to cover people, who earn enough to meet their basic needs, but not always enough to pay a health insurance premium.

Right now, a mother with one child would need to make less than $22,400 to be eligible for Medicaid.

Gov. Brad Henry has discussed expanding the state's Medicaid coverage, but a formal plan has not been announced.

Henry's spokesman Paul Sund, said Henry expects to have a plan drafted by February when he makes his state-of-the-state address.

Last session Rep. M.C. Leist, D-Morris, filed legislation to allow the state to apply for a waiver that would net federal matching dollars to expand its program.

Leist said lawmakers are discussing the idea of helping employers to subsidize health insurance premium copays.

A plan like that could cost the state nearly $12 million next year if approved, Leist said.

``It's just a matter of priorities. We just might have to shape money around,'' Leist said. ``You pay for it anyway, whether it be at the hospital or in your health insurance premiums.''

Last year the state's hospitals doled out $587 million in care to Medicaid recipients and the uninsured, but only received $434 million in state and federal tax dollars to cover it.

Oklahoma's push to include more people in its Medicaid system comes as other states are cutting services to save state dollars.

A study conducted by the Center on Budget and Policy Priorities reported that more than 1.2 million low-income Americans, including 500,000 children, have lost health insurance coverage because of cuts to 34 state programs.

In other states, lawmakers are shifting dollars and limiting health care coverage to include more people in Medicaid programs.

In Oregon, officials limited the health services and procedures covered under Medicaid so the state could cover 60,000 additional people.

In Utah, federal dollars helped the state lower a $50 enrollment fee for people who don't make more than 54 percent of the federal poverty level.

Leist said Oklahoma's plan to expand its Medicaid coverage is ``just a notch past the talking stage,'' but something he thinks will have the support of lawmakers.

``I've got the bill ready and waiting here,'' he said. ``I'm just waiting for the governor to flesh out some of the details.''

For Hill, discussion of expanding benefits is a step in the right direction.

``This is something I think about everyday,'' Hill said. ``If my children didn't have health insurance, I would be all over them like a rug. But it's just me and I pray everyday that God keeps me healthy.''