Kalena Thomhave

The American Prospect
Stark differences color red- and blue-state lawmakers’ policy choices—which makes all the difference in residents’ well-being.

, Illustration by Alex Nabaum

 

In a conference room with harsh fluorescent lights, several bins sit on a large table, each one overflowing with returned mail. On the floor, there are even more bins for the staff at Hunger Free Oklahoma in Tulsa to sort through. The organization’s executive assistant sits me down on a sofa outside the conference room and cheerily asks me about myself—Oklahomans like to “visit,” as they say. And with a rueful smile, she apologizes for the “mess” of mail bins that trickle out into the hall.

These hundreds of letters spotlight the massive attempt by the statewide community group to connect kids who aren’t receiving the free meals that they expect during the school year with the additional funds for food during the summer. Also known as SUN Bucks, the federal Summer EBT program provides benefits to families of children eligible for free or reduced-price school lunches during the summer months. Children receive $120 on electronic benefit transfer (EBT) cards—$40 for each summer month.

In Oklahoma, nearly a quarter of children live in food-insecure households, one of the highest rates in the country. The Annie E. Casey Foundation’s KIDS COUNT, its annual compilation of child well-being data, ranked Oklahoma 46th in the nation overall—as well as 49th in education and 45th in health.

Yet Oklahoma’s Republican Gov. Kevin Stitt rejected the roughly $48 million of funding for the 2024 Summer EBT program and announced in August the state would also not participate in the program next summer. Oklahoma was one of 13 Republican-led states that declined this year’s summer grocery benefit. “Oklahomans don’t look to the government for answers, we look to our communities,” a spokesperson for the governor said in a statement regarding the decision to decline the funding, which they referred to as a “handout.”

Halfway across the country, KIDS COUNT ranked Connecticut 8th overall, 3rd in education, and 11th in health. But the state, which also participated in Summer EBT this year, faces a hunger problem as well—more than 15 percent of children live in food-insecure households. In fact, Connecticut was one of the first states in the country to pilot its own program in 2011.

The two states weren’t always such polar opposites. For instance, in 1959, Oklahoma and Connecticut residents had roughly the same life expectancy. But fast-forward 60 years, and the numbers have significantly diverged. Connecticut now ranks among the top ten states in average lifespan, with an average life expectancy at birth of 80.8 years in 2019. That same year in Oklahoma, the average lifespan at birth was more than four years lower at 76.1 years, among the bottom ten states in life expectancy. The national average life expectancy in 2019 was roughly 79 years.

As state policy choices widen, so have the differences in state residents’ health outcomes.

Gun control policy is another key indicator of life expectancy. But Connecticut has passed background checks, permit policies, and secure storage requirements, while Oklahoma has few gun control laws on the books. In fact, in 2019, the state passed a law allowing open carry without a permit or license in most public places. In 2022, Oklahoma had the 13th-worst rate of gun violence in the U.S., while Connecticut had the 45th-worst rate.

Jennifer Montez, professor of sociology at Syracuse University, has considered how the polarization of politics and policy contributes to health differences among state populations. Life expectancy in particular may have precipitously declined nationwide in 2015, but it had been stagnating much longer before that. And in the U.S., there are profound differences in residents’ lifespans across place—gaps that have been growing for decades.

In fact, Montez and her research team found that Connecticut passed the most progressive policies between 1970 and 2014, while Oklahoma passed the most conservative ones. Connecticut has passed a refundable Earned Income Tax Credit, while Oklahoma cut income taxes and refused to expand Medicaid until voters passed a ballot initiative and forced the state to do so. Meanwhile, life expectancy in both states did get better, but in Connecticut it increased by 9.7 years and in Oklahoma it grew by just 5.0 years, as of 2019.

“You have two states that [we]re the same, were pretty middle-of-the-road in terms of life expectancy, but they take opposite trajectories,” says Montez. Some states, she says, took action to “invest in [the state] population’s overall economic well-being and health.” Connecticut is one of them. “And you had other states that took a much more”—she pauses, as if searching for a diplomatic way to describe it—“they took a very different approach.”

As the political parties nationalized, there were only two approaches that most state governments would take. Policies “polarized between and bundled within” states, as Montez has described them, were tied to the governing party’s ideology, creating more homogenous state policy landscapes based on whether a state was led by Democrats or Republicans.

As differences in state policy choices have widened, so have the differences in outcomes among state residents. State government, after all, plunges into the day-to-day minutiae of our lives through decisions about health, education, social services, criminal justice, and more. For example, families in some states get money to keep their kids fed during the summer; in other states, they don’t. Oklahoma leaves it up to communities—and sometimes separate governments—to fill the gaps.

ON THE CHEROKEE RESERVATION in northeastern Oklahoma, the Woody Hair Community Center appears suddenly amidst lush trees on a single-lane highway, the building’s sleek new construction juxtaposed against the deep-green foothills of the Ozarks. The $21 million center in tiny Kenwood (population 904) is home to early-childhood facilities, a nutrition center where seniors enjoy lunches, a large softball field, two playgrounds, a rooftop garden, a large gym, and even concession stands.

In the Head Start area, children lie on napping mats; we tiptoe around their sleeping forms to view one of the playgrounds and its shiny, new plastic equipment.

Even the smallest rural community won’t be left behind by the government—the Cherokee Nation government, that is. “These are our people,” says Kim Chuculate, senior director of Cherokee Nation Public Health, her arms extending to gesture around her in the lobby of the center. The community center is meant to “be what it needs to be for the community,” she says, which can be many things at once. For example, while the facility can serve as a basketball court for high school games with concession stands where school clubs can fundraise by selling food, the community center is also outfitted to serve as a tornado shelter. And each night of the week, different sports are offered in the gym—sometimes it’s the popular new game pickleball and sometimes it’s stickball, a traditional Cherokee game.

The bumpy route back to Tahlequah, capital of the Cherokee Nation, includes other hints of the investment taking place across Cherokee Nation lands. Construction is under way at Tahlequah’s own medical center, a massive campus where a visitor can see Cherokee art—paintings, ceramics, and more—through the windows of most of the buildings. (Building construction rules mandate that 1 percent of every project’s budget goes toward purchasing Cherokee art for display.)

OCT24 SPECIAL Thomhave graphic.jpg

SOURCE: U.S. MORTALITY DATABASE, UNIVERSITY OF CALIFORNIA, BERKELEY

 

More than 1 in 8 people in Oklahoma are Native American; there are 38 different federally recognized tribes in the state. The U.S. government force-marched the Cherokee and other Southeastern tribes from their homelands to Oklahoma during the ignominious 19th-century period known as the Trail of Tears. This episode set in motion the Native communities’ disproportionate rates of poverty and chronic health issues like diabetes and high blood pressure that many tribal members suffer from today.

Health care, as a result, is a major focus of the Cherokee Nation, which has spent millions constructing hospitals, clinics, and community centers in remote rural areas.

Many of the Oklahoma state government’s own public-health investments pale in comparison to tribal-run hospitals and clinics that are coordinated by tribal governments in the eastern part of Oklahoma. It’s the tribal communities that have stepped up to the challenge of feeding Oklahoma children in the summer—whether or not they are Native.

With assistance from Hunger Free Oklahoma, the Cherokee and Chickasaw Nations coordinate the federal SUN Bucks program that serves children living within Cherokee, Chickasaw, Choctaw, Muscogee (Creek), and Seminole Nations. Any child on these tribal lands can receive benefits, and as tribal lands are vast and include the state’s second-largest city of Tulsa, roughly 105,000 children were eligible for benefits this summer.

But even though tribal governments are indeed helping to fill the gaps in areas like health care, it’s not their responsibility—nor can it be: Unlike the eastern part of the state, most of western Oklahoma is not tribal land. And usually, only members of federally recognized tribes can use tribal-run facilities. When COVID-19 vaccines were scarce, however, the Cherokee, Chickasaw, Choctaw, Citizen Potawatomi, and Osage Nations provided vaccines to any member of the public.

Meanwhile, dozens of rural hospitals in the state have closed in the past 15 years, and according to a 2024 report, 22 rural hospitals in Oklahoma are at risk of shuttering—roughly a third of those currently operating.

“Sometimes it feels like we’re filling a gap that shouldn’t be there,” says Chief Chuck Hoskin Jr., the principal chief of the Cherokee Nation. The investments across the reservation are “visual evidence that our priorities are [in] health care,” he says, making sure someone “is as healthy as they can be before they even step in a hospital.”

Shiloh Kantz, a Cherokee citizen and executive director of the Oklahoma Policy Institute (OK Policy), says that her tribe is “not a business or corporate-centered government, [but instead] we are a people-centered nation.” That’s “how we’re doing policy,” she says.

When Oklahoma does adopt more progressive policies like Medicaid expansion, it’s often because people have demanded change.

Other tribes have also invested heavily in health care. Darita Huckabee, who was previously a lobbyist for the Indian Nations Council of Governments in Tulsa, is a Choctaw citizen and has fond memories of the treatment her father received in tribal facilities. She describes how he’d get an asthma diagnosis in Denver, but the Chickasaw-run hospital in the small town of Ada, open to any tribal citizen, would administer treatment. It was “the best health care I’ve ever seen,” she says, adding that the tribe’s investments in preventative health care are “going to change our world.”

In 2019, the economic impact of tribal investments in business, health, education, and jobs in Oklahoma was a remarkable $15.6 billion, according to a 2022 Oklahoma City University report.

In contrast to the tribes’ significant investments, many miles and one sovereign government away, Oklahoma City embraced the conservative preference for shifting policy responsibilities from the federal government to the states. Beginning in the 1980s, Washington gradually embarked on devolution—the transfer of governing power to the states as Congress converted program funding to fixed block grants. State lawmakers had greater flexibility: They could either cut services or increase them.

Many states have also controlled city policies by preempting localities, often but not always Democratic cities in Republican states, from passing their own policies, keeping city residents from receiving benefits like paid sick leave, higher minimum wages, or tenant protections. Moreover, today many states prioritize electing part-time, “citizen” lawmakers who have other jobs (and other priorities). Since the lawmakers don’t always have legislative staff to assist with research on these topics—Oklahoma actually has fewer staff than it did in 1979—they rely on industry lobbyists and groups that promote model bills, like the conservative American Legislative Exchange Council (ALEC), that have stepped in to fill those gaps. ALEC, in particular, has had notable successes in Oklahoma, especially with proposals to cut or ban health care services and other programs.

“We [are] governments moving in two different directions,” says Hoskin, referring to Oklahoma and the Cherokee Nation. “The state of Oklahoma has retreated from the public sphere,” he says, while “[we have] spent the last two decades with our foot on the gas, pouring hundreds of millions of dollars into the public good.”

THE STATE OF CONNECTICUT, however, has accelerated its pace of life-changing investments. In recent years, state lawmakers have raised the minimum wage and passed paid family leave policies and a state EITC. Last year, the state started the country’s first Baby Bonds program: Any child covered by Medicaid also receives a $3,200 trust fund at birth, which the state treasurer monitors and invests. When a child reaches adulthood, they can use the funds to buy a house, further their education, save for retirement, or start a business.

“In Connecticut, there’s a sense of civic pride about passing progressive legislation—and trying to be the first state to pass certain legislation,” says Mark Abraham, executive director of DataHaven, a New Haven–based local and state statistics hub.

Indeed, Connecticut was the first state to expand Medicaid after the passage of the Affordable Care Act. It was also the first to pass paid sick leave requirements for private employers. These “bundles” of progressive policies reflect policy choices that are “internally consistent,” says Montez of Syracuse University. “You don’t see Connecticut implementing a generous EITC but not raising the minimum wage.”

Some of this work in Connecticut was inspired directly by the White House. For example, when Connecticut raised the state minimum wage to $10.10 in 2014, that number matched the Obama administration’s recommendation for a minimum-wage hike (and the raise the president gave to federal contract workers).

Policy bundles are also, of course, seen in Oklahoma and other conservative-led states, where legislation championed by groups like ALEC tends to follow other pieces of recommended proposals.

CARLY PUTNAM, AN ANALYST AT OK POLICY, is more than ready to talk to me about Oklahoma’s policy shortcomings, telling me that her notes for our conversation are nine pages long.

“We have not prioritized investing in state services,” she says bluntly, referring to her state government. “We have repeatedly chosen to disinvest from systems that are proven to help Oklahoma children, families, and communities, and we’re reaping the products of that harvest now.”

The shift is even starker between 2000 and 2024; according to OK Policy, the state’s budget for the 2024 fiscal year is 12 percent smaller than the budget for the 2000 fiscal year, adjusted for population and inflation. As in many Republican states, Oklahoma legislators are quite interested in cutting taxes. During this year’s state legislative session, Republican House Speaker Charles McCall told reporters that “the people of the state of Oklahoma need to get a pay raise through a tax cut,” and that “we need to first address that before we address some other spending matters of the state.”

Darita Huckabee, a retired lobbyist, remembers the “tax-cutting frenzy” the legislature went on beginning in the mid-2000s, with repeated cuts to the state income tax. And because Oklahoma requires a three-fourths majority in the legislature for any bill that raises revenue, once a tax is cut, it will be very difficult to reverse those cuts. The goal, she says, was to attract businesses that usually preferred Texas, a supposed competitor. Texas, of course, does not have a state income tax. Moreover, Oklahoma can’t begin to match what Texas, the eighth-largest economy in the world, has to offer.

Still, Oklahoma is tied for the second-lowest corporate income tax rate in the country. Yet for all politicians’ talk of attracting businesses, Oklahoma has instead served as a pawn for tax incentive schemes. When it tried to encourage Panasonic and Tesla to open facilities in the state, Oklahoma offered hundreds of millions in tax subsidies, which likely boosted the offers from Kansas, where Panasonic landed, and Texas, where Tesla ended up. Tulsa, looking to woo Tesla to Oklahoma, even altered a local statue to look like Tesla CEO Elon Musk. “When talking to key members of the team that would need to move … Austin was their top pick to be totally frank,” Musk said—as if he hadn’t known that previously.

Oklahoma has “chosen to prioritize business rather than people, but actually investing in people is what attracts business,” says Kantz of OK Policy.

Though Oklahoma may be trying to diversify its economy with bids for tech and manufacturing workers, the state still largely relies on resource extraction, with oil and gas extraction making up approximately 12 percent of the state’s GDP in 2022. With fossil fuel extraction following a boom-and-bust cycle, the state’s revenue—and accompanying state investment—often does too.

INSTEAD OF STATE INVESTMENT, when transformation does occur in Oklahoma it’s often thanks to generous funding from local organizations. About a decade ago, Oklahoma was regarded as a leader in early-childhood education, largely championed by nonprofits and philanthropies. Still, in 1998, it was Oklahoma, and not a blue state, that was the first state to implement publicly funded, universal preschool for all four-year-olds.

“We have seen progress here and there,” said David Blatt, director of research and strategic impact at Oklahoma Appleseed, a public-interest law firm. “But the overall feeling is like you’re bailing a leaking boat with a teaspoon.”

Oklahoma’s K-12 education system is not exactly among the country’s innovators. The state has some of the worst rates for per-pupil spending and teacher pay. Its state superintendent of public instruction, Ryan Walters, has focused much of his time on touting his mandate that public schools teach the Bible (even though they seem unlikely to do so). Education funding relies in part on the state’s volatile gross production tax levied on the oil and gas industry. This severance tax is the state’s third-biggest source of revenue after the personal income tax and sales tax.

When Oklahoma does adopt more progressive policies—like Medicaid expansion—it’s often because people have demanded change. In 2020, Oklahoma voters approved a ballot measure to expand Medicaid to low-income adults without children, making an additional 215,000 people eligible for the health insurance program.

Residents are also set to vote on a minimum-wage ballot measure in November. The current minimum wage in Oklahoma matches the federal minimum of $7.25, so any increase could be big for low-wage workers—and judging by the success of previous ballot measures on raising wages, minimum-wage ballot measures are unlikely to lose.

But the spectacle of voters flexing their direct-democracy muscles unnerves Republicans. State lawmakers have moved to restrict ballot measures. This year, the governor signed two bills that will require ballot initiative sponsors to pay filing fees; one measure also requires that a petition signer include several pieces of information that exactly match their voter data on file, likely making it harder for organizing groups to get issues on the ballot.

CONNECTICUT IS NOT IMMUNE from poverty, inequality, and health disparities. The state has one of the most regressive tax systems in the country. According to a 2023 United Way report on cost-of-living indicators, 39 percent of Connecticut residents struggle to afford their basic needs. While Connecticut has the second-highest per capita income in the country, unsurprisingly, it also has some of the highest rates of income inequality and racial segregation.

But health care is one of Connecticut’s bright spots: Just 5.1 percent of the state population is uninsured, making Connecticut one of the best states for health care access in the country, which is reflected in its health outcomes. Still, there are widespread racial disparities in health care: While Connecticut has the lowest infant mortality rate in the country (4.8 deaths per 1,000 births), its infant mortality rate for Black mothers is more than twice as high—11.7 deaths per 1,000 births.

Oklahoma has opted to rely on “communities” to bridge widening chasms in hunger, health, education, and a host of other social sectors, producing outcomes that are worse across the board, with limited access to health care as well as a shortage of health providers. Kantz, the state health care expert, has a teenage daughter with a rare disease. Since the beginning of the year, she says her daughter has gone through four pediatric neurologists as doctors have left the state.

Her family was originally driving three hours round trip from Tulsa to Oklahoma City to reach one, but now they must drive eight hours round trip to Dallas. Another specialist is a plane ride away in Pittsburgh. Once her daughter graduates from high school, Kantz says, it might be time for her family to leave the state.

The policy differences between states that provide robust services and states that eliminated them, or never offered them in the first place, have impacts that reverberate across people’s lives. Daily existence becomes more difficult than it would be in a place that prioritizes improving public services and easing residents’ hardships.

The divergence between Connecticut and Oklahoma is an extreme example of what’s occurring across the country as Republican states cut taxes and services and create environments where residents are beholden to the policy whims of corporations, interest groups, and wealthy donors, all who have a vested interest in low taxes and limited social spending.

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Kalena Thomhave is a freelance journalist and researcher based in Pittsburgh. She is a former Prospect writing fellow.

 

 
 

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