For stories in the weekly Overextended Oklahomans series, journalists from participating newspapers have looked at the burdens exacted by payday lending, childhood hunger and the shortage of neonatal care. In one recent installment, reporting team member Caleb Slinkard offered a detailed exploration of how a scarcity of dental care is impacting poor and rural Oklahomans. Continue reading
The oral health of a state or community can serve as an interesting lens for examining economic health. That is the message that a series from newspapers in the Community Newspaper Holdings Inc. chain recently brought to its readers in Oklahoma.
Ron Jackson of Oklahoma Watch wrote one of the best stories I’ve seen laying out the policy dimensions and the human face of the decision by some states to forgo Medicaid expansion.
You’ll recall, of course, that when the Supreme Court upheld the Affordable Care Act it made the Medicaid expansion a state option, not a requirement.
That created an anomaly that the law’s authors did not intend: People with incomes at the poverty level and up to four times the poverty level (roughly $92,000 for a family of four) will be able to get subsidized insurance in the state-based health exchanges starting in 2014. But people who are poorer than that – who are below the poverty level and who are not now eligible for Medicaid in their state (which is way more restrictive than most people imagine) won’t get subsidies.
If their state doesn’t expand Medicaid, they get nothing.
Oklahoma is among the states rejecting the coverage expansion – saying it will leave them on the hook for untold millions of dollars, even though the federal government has promised to pick up the full cost for three years and 90 percent over the long haul.
Jackson described what that means to “tens of thousands of low-income parents.” Continue reading
The Tulsa World‘s Ziva Branstetter has, for months now, been doggedly investigating the billing practices of the Emergency Medical Services Authority, an agency that provides ambulance service to many residents in and around Tulsa and Oklahoma City. The service is largely funded by utility fees which, unless users specifically opt out, should cover the payers’ out-of-pocket costs.
Instead, Branstetter has found, EMSA has followed a number of apparently deceptive billing practices, including sending bills that list a “due from patient” balance of something like $1,100, even though that amount is actually covered by the utility fee. It also unilaterally implemented a policy making patients responsible for the balance if they don’t provide insurance information within 60 days, while providing lavish benefits to employees and executives.
Branstetter’s latest efforts have been directed toward innovative ways of proving EMSA’s sketchy billing practices, as well as uncovering the details of benefits given to the public utility’s CEO. For a full list of Branstetter’s stories on the subject, databases and documents, as well as a summary of the issues at hand, visit the World‘s excellent landing page for the investigation.
Writing for the local NPR StateImpact outlet, Logan Layden looks at how dental programs for the needy are coping in the absence of state funding. In the 2010 state budget crisis, Layden writes, “Funding for several programs, including Dentists for the Disabled and Elderly in Need of Treatment, was totally eliminated.”
Among those was Oklahoma’s D-Dent, which provides a sort of superstructure that takes care of logistics and tests in order to allow dentists to donate their work to the needy and elderly. Since the cuts, the statewide program has gone from supporting about 800 patients a year to about 600. They no longer get state funds, though they still rely on the health department for most of their referrals, as well as a little moral support.
“We here are entirely supportive of this program,” Jana Winfee, Chief of Dental Health Services the Department of Health, said. “They have our support, just no funds.”
For more on NPR’s StateImpact project and a list of current participants, check out their lab.