814,700 Ohioans would lose Medicaid coverage under AHCA
Posted June 22, 2017 in Press Releases
Both House and Senate versions of the American Health Care Act (AHCA) make steep cuts to Medicaid and effectively end Medicaid expansion. With 25 percent of its population on Medicaid and more than 723,000 people covered by expansion, Ohio would be especially harmed by the American Health Care Act (AHCA), according to a new report from Policy Matters Ohio.
The report contains county and Congressional district data that projects the dollars lost due to Medicaid restructuring, the number of people affected, the drop in insurance rate and the potential economic impact.
The AHCA would change Medicaid to a per capita cap structure, which caps federal funding per Medicaid enrollee. The federal government would save money because the cap is set at a growth rate lower than Medicaid costs are expected to grow. States would be responsible for covering all costs above the caps. To maintain current Medicaid levels, Ohio would have to spend $6.4 to $8.5 billion by 2025 or cut some combination of Medicaid payments to providers, service options and eligibility for Ohioans.
"Under per capita caps, additional federal funds do not get triggered when a state faces a spike in health care costs from a public health emergency like Ohio’s opioid epidemic,” said Wendy Patton, Senior Project Director at Policy Matters Ohio. “Additional costs would fall to states."
As states face growing funding cuts under per capita caps, the people who will lose most are those who are expensive to treat: senior citizens, special needs children and anyone with a pre-existing condition, like Jane Hash of Akron who suffers from Osteogenesis Imperfecta, a genetic disorder that causes bones to easily break.
"Reducing Medicaid funding would have a devastating impact on my life. I receive 98 hours of non-agency home care every week because I require assistance with activities of daily living,” Hash said. “Any reduction in home care hours would mean I would have to skip meals or spend my days in bed or not have assistance to use the bathroom or, worse case scenario, I would be removed from my home."
The AHCA de-funds Medicaid expansion, which allowed 723,000 Ohioans to enroll in Medicaid. The Urban Institute projects that under the likely loss of Medicaid expansion coupled with cuts to enrollment due to per capita caps, 814,700 Ohioans will lose Medicaid coverage by 2022.
The bill sharply rolls back the federal match rate for Medicaid expansion enrollees, and by 2021, Ohio will be responsible for an additional $735.5 million to maintain coverage for its expansion enrollees. Under serious budget shortfalls, it is unlikely Ohio will be able to maintain costs of Medicaid expansion over time. Meanwhile, the AHCA cuts taxes to high-earning households starting in 2018— amounting to $663 billion in lost revenue over 10 years.
Federal Medicaid expansion funds allowed Ohio’s smaller hospitals and health centers to care for more people. Because of expansion, the Community Health Center of Greater Dayton grew from three to six health centers.
"Taking away this coverage does not make the need go away, “ said Dr. Matthew Noordsij-Jones who works at the center. “The bottom line is that Ohioans will be sicker and more people will die under the AHCA's cuts to Medicaid."