Report outlines new threat to Ohio Medicaid
Posted June 06, 2019 in Press Releases
The Feds scuttled ‘Healthy Ohio’ plan once but lawmaker goes for it again
If a new proposal goes forward, sick Ohioans could be denied medical coverage for things like oxygen, an ambulance ride, and addiction treatment, simply because they can’t afford it, according to a report from Policy Matters Ohio.
The latest iteration of the so-called “Healthy Ohio Plan” (HOP), put forward by State Representative Jim Butler would apply to 1 million Ohioans who use Medicaid. Ohio lawmakers passed a similar plan in the 2016-17 budget, but it was ultimately nixed by the federal government. The new HOP would charge “premiums” (monthly payments) for most non-elderly adults who use Medicaid. Those who pay the premiums get services through a program called the ‘Plus’ plan. Those who can’t pay or miss too many payments are dropped into an inferior ‘Basic’ plan. Wards of the state, people who are pregnant, or have cancer, severe and persistent mental illness, or who are making ‘satisfactory progress’ in addiction treatment, are exempted.
The new proposal emerged briefly in one version of House Bill 166, the state budget bill for 2020-21. Lawmakers removed it before the House vote, but it could come back later in the budget process or as a stand-alone bill.
“Butler’s proposal is based on the ‘Healthy Indiana Plan,’ which hurt a lot of people,” said Wendy Patton, Senior Project Director and report author. “Sixty-thousand eligible people either didn’t get in or dropped out of the Indiana program because they couldn’t afford the premiums. Almost half of those eligible for the Healthy Indiana Plan between February of 2015 and November of 2016 lost services because they couldn’t pay.”
In the new HOP plan, monthly premiums would start at a minimum of $1 for those earning less than $600 a year and rise, based on 2% of annual income, to $20 per month. Those who pay regularly for the ‘Plus’ plan would get services that presumably include federally mandated services as well as some Ohio-specific services, like prescription drugs. Those who can’t pay the premiums or miss payments would be put into a skimpier ‘Basic’ plan and could be denied some services offered today, like prescription drug coverage or treatment for addiction.
Health insurance payments often fall to the bottom of the list when people of very low income face hard choices between rent, gas, school clothes and food. In 2016, many people argued that Butler’s Healthy Ohio plan would cause a sicker, less prosperous state. The overwhelming majority of the 956 comments submitted on the proposal to the Centers for Medicare and Medicaid Services (CMS) expressed concern and opposition. CMS ultimately turned it down.
“The Healthy Ohio Plan will punish people by limiting access to health services if they can’t afford to pay,” Patton said. “The federal government turned down a similar plan in 2016. There is no need for a second round with this proposal. It remains unhealthy for Ohio and Ohioans.”