Ohio House budget curtails Medicaid expansion
Posted May 02, 2017 in Press Releases
Provisions in the House budget bill (HB 49), passed today, create barriers to participation in Ohio’s Medicaid expansion, a program that has been remarkably effective in delivering quality care to 723,000 Ohioans.
Instead of simply covering working-age Ohioans making up to 138 percent of the federal poverty line, HB 49 limits Medicaid expansion coverage to Ohioans who are 55 years and older; employed; have intensive health needs; or are enrolled in school, occupational training or substance abuse treatment.
Such work requirements ignore the fact that 43 percent of Medicaid expansion enrollees were already employed between 2014-2015, and that 75 percent of those not employed were looking for work. It is that group – job seekers – who will be hurt by these changes. But others could easily fall outside of eligibility under these provisions: a husband who cannot work because he is taking care of an ill wife or someone who suffers from a mental illness not included as an “intensive health need.”
The budget bill attacks Medicaid from another angle, reviving last year's failed “Healthy Ohio” plan for the Medicaid expansion group, which would have cut enrollment by 125,000. "Healthy Ohio" was a proposed waiver the state filed last year, which would have charged Medicaid enrollees premiums and locked enrollees out of the program for non-payment or missing paperwork deadlines. States can seek waivers from standard Medicaid rules for demonstration projects that increase access to Medicaid for low-income people and improve quality of coverage. Because Healthy Ohio instead put up barriers to coverage, the federal government denied the waiver request in September 2016.
Now, despite the fact that a thousand Ohioans wrote letters to the federal government last year in opposition to "Healthy Ohio", the House of Representatives wants the state to go back and see if they can get approval under a new federal administration.
Ohio’s Medicaid expansion program has been profoundly successful. Under it, Ohio’s rate of uninsurance among low-income residents fell to the lowest in state history. Fully 75 percent of expansion enrollees came into the program without prior health coverage, and a recent Ohio State University analysis showed that 95 percent would not have been able to get health coverage through other means. Of Ohio’s Medicaid expansion enrollees, 70 percent had chronic conditions like diabetes, hypertension and depression that, if left untreated, can result in costly, even deadly, medical crises. After gaining health insurance, expansion enrollees overwhelmingly reported better management of chronic conditions, increased use of preventative care, fewer unmet medical needs and reduced medical debt.
Ohio Medicaid expansion’s success in connecting low-income residents with consistent health care stands in sharp contrast to HB 49’s embrace of work requirements, premiums and lock-outs, which we can expect will reduce access for those who need it most.