Guest blogger: Here’s why Ohio should leave Medicaid alone
Posted on 04/08/16 in Revenue & Budget
This week, the Ohio Department of Medicaid (ODM) initiated the process of making it more difficult for low-income Ohioans to keep Medicaid coverage.
Medicaid was created to provide health care for people who are too poor to afford necessary medical services. It helps them get healthier and with better health, be more productive. It moves people to independence.
But Ohio is about to make it harder for Medicaid to serve these purposes. The state budget bill signed by Gov. John Kasich directed ODM to apply for a waiver for the so-called “Healthy Ohio” plan. The plan would shift over 1 million Ohioans enrolled in Medicaid into a new program that imposes premiums on adults earning less than 138 percent of the federal poverty level ($16,394 for a single person without dependents). Healthy Ohio will lock individuals out of coverage for non-payment and impose yearly and lifetime caps on coverage.
Ohio has published a public notice and request for comment on the waiver request, which would allow the state to sidestep federal Medicaid requirements. The Centers for Medicare and Medicaid Services will decide the request.
This is the first step in the process, and it comes as no surprise to Medicaid consumer advocates.
Implementing the misnamed Healthy Ohio would be a giant step backward for Ohio – for the public and private health of its citizens. Ohio has a successful Medicaid expansion program. Over 657,000 Ohioans gained coverage in fiscal year 2015 as a result of the expansion. Ohio’s uninsured rate has dropped dramatically. At least 50 percent of those who now have access to care are working. Healthy families contribute to healthy communities and help Ohio prosper.
Ohio struggles with many public health issues. Our infant mortality rate is the highest among the 10 most populous states in the nation. The opiate epidemic is destroying thousands of families. More than 15 percent of Ohioans live in poverty and another 19 percent have household incomes so low that they often rely on food pantries to make ends meet. A quarter of Ohio’s children suffer from food insecurity – sometimes their families don’t know where the next meal will come from. Creating barriers to health care for families and communities struggling to address these problems will hurt those most in need and impede Ohio’s efforts to improve population health.
There are no compelling economic reasons for Ohio to backpedal on Medicaid expansion. Ohio is under-spending its Medicaid dollars to the tune of over $1 billion, according to the latest information presented to the legislators on the Joint Medicaid Oversight Committee. The populations that drive up Medicaid costs – seniors and people with disabilities (known as the aged, blind and disabled population) – do not have to enroll in Healthy Ohio. Ohio is already undertaking a number of initiatives to control costs and improve care. The administrative changes that will be required by creating a new program – shifting over 1 million Ohioans into that program, and administering hundreds of thousands of complicated swipe card accounts – will likely overshadow any possible cost savings.
The waiver proposal has been justified as a tool to “incentivize” Medicaid enrollees to take responsibility for their health and introduce them to commercial market features (like paying for health care), ostensibly to ease the transition out of public assistance. However, neither ODM nor any legislator has produced any objective evidence that Ohioans who depend on Medicaid do not take responsibility for their health. Providing better access to education and job training and not erecting barriers to health care will help Ohio families succeed at work.
Suggesting that Ohioans who rely on Medicaid for health care don’t take responsibility for their health derides individuals who are working and caring for their families, those who struggle with chronic health problems that keep them out of work, and those seeking the education and training necessary to move up the economic ladder.
The Healthy Ohio Program is not good for Ohio, and everyone who is concerned should take the opportunity to let the Ohio Department of Medicaid know. The public has two opportunities to comment. We can either submit comments in writing, or attend one of the two public hearings and testify. You can find information about this process in the ODM Public Notice.
The Ohio Poverty Law Center, Policy Matters Ohio, and many other organizations have studied Ohio’s proposal, and the impact of similar proposals on access to health care. You can find an in-depth review of the proposed waiver here and examples of comments here. We encourage every organization that serves struggling Ohioans, and Ohioans whose families, friends and communities will be affected by the Healthy Ohio plan, to express their concerns about this unhealthy proposal.
-- By Linda Cook
Linda is senior staff attorney for the Ohio Poverty Law Center.