Fate of health care coverage for hundreds of thousands in the hands of the Senate
Posted August 02, 2017 in Press Releases
This month, the Ohio Senate may finally settle the 2018-2019 budget. Their decisions on whether to override some or all of the governor’s vetoes will have a profound impact ranging from Medicaid health care coverage to county and transit agency budgets.
Governor Kasich made 47 vetoes to the budget and the House overrode 11 of them. Nine of those overrides had to with Medicaid. In a new issue brief, Policy Matters Ohio details the Medicaid questions that remain unanswered a month after the budget was due.
“During budget negotiations, lawmakers continuously sparred over Medicaid,” said Policy Matters senior project director and report author Wendy Patton. “Being Ohio’s largest program, it touches many aspects of the state budget well beyond health care.”
In 2013, Governor Kasich accepted federal funding to expand Medicaid to cover Ohioans under 138 percent of the federal poverty line – about $28,180 for a family of three. Medicaid expansion covers 723,000 more Ohioans and supports health care jobs, especially in rural areas. The House and Senate passed budgets that would freeze Medicaid expansion enrollment in 2018. Governor Kasich vetoed that provision and the House did not override it. But the House overrode others, including tighter legislative controls on state funds for Medicaid expansion.
Legislators added the so-called the “Healthy Ohio” plan to the 2016-2017 budget, requiring the state to apply for a waiver of Medicaid rules to charge Medicaid enrollees premiums and other unconventional approaches. Boosting premiums reduces enrollment: The waiver application forecast a drop of up to 140,000 enrollees annually. The federal government rejected the plan, but the new budget bill mandates re-submission. The governor vetoed it and the House overrode the veto.
With a budget of $27.07 billion in 2018 and $28.19 billion in 2019, Medicaid is Ohio’s largest single health insurer, covering around 3 million Ohioans. About two-thirds of its funding comes from federal dollars. The new budget moves a Medicaid provider tax out of the state sales tax base, eliminating a revenue stream of more than $200 million a year for counties and transit agencies with a local sales tax levied on the state base. The legislature found a fix that would keep counties and transit agencies whole, but the governor vetoed it. The House overrode the veto.
“The Senate has the opportunity to protect health care for possibly hundreds of thousands of Ohioans and make sure counties and transit agencies don’t face devastating budget shortfalls in 2019 and thereafter,” Patton said. “Senators' choices, in concurring with House overrides or letting the governor’s vetoes stand, will make a huge difference in people’s lives.”