"The average life expectancy in Oklahoma is the fourth-lowest in the country … and then when it comes to heart disease, cancer, stroke, heart disease incidence, they all tend to be a little bit higher in Oklahoma," said WalletHub analyst Jill Gonzalez. "I don’t think it helps that Oklahoma has the second-highest uninsured rate for adults in the country."
Oklahoma’s doctor-to-patient ratio, infant and child mortality rates, and average monthly health insurance premium are also all among the 10 worst in the nation.
While WalletHub considered measures of cost, access and outcomes, a big part of Oklahoma's poor ranking is the adult uninsured rate. Oklahoma Policy Institute’s Carly Putnam said with nearly one in four adults not having health insurance, they’re visiting emergency rooms to get care for conditions exacerbated by not being able to visit a primary care physician.
"That means that health coverage is more expensive for everybody because you and me are helping subsidize people who don’t have other options. It also means that those hospitals and those safety net providers, then, are operating a little bit closer to the red if not in the red," Putnam said.
Putnam said not all of the high uninsured rate can be attributed to the state not expanding Medicaid to cover adults who don’t qualify for it but aren't eligible for premium subsidies under the Affordable Care Act, either.
"Ther are some people in the state who would be eligible to purchase coverage on healthcare.gov who believe that because the state didn’t take Medicaid expansion, the state’s just not participating in the ACA at all," Putnam said.
Oklahoma’s child uninsured rate is also among the highest in the nation, with roughly one in 10 kids not having health care coverage.