As the July 1st deadline for the state budget looms, Ohio advocates are expressing concerns about the Senate Finance Committee version of the state budget; in particular, the changes the legislation makes to the state’s Medicaid program. Not only does the bill maintain the House version’s poorly drafted work requirements for enrollees, it also freezes enrollment in the Medicaid expansion—a program that has been successful in increasing coverage and improving the health and financial stability of some of Ohio’s most vulnerable citizens.
Voices is a member of the Medicaid Coalition because we recognize that with more than 1.2 million of Ohio’s 2.6 million children covered by Medicaid and CHIP, any changes to these programs deeply impact kids and families. Throughout the budget process the Medicaid Coalition has engaged in thoughtful conversations around ways to improve the Medicaid program, including solutions recognizing the General Assembly’s wish for additional guardrails on Medicaid. Unfortunately, the current version of the bill, does not take into account these solutions. The Senate changes will ensure hundreds of thousands of Ohioans will no longer have access to primary and preventative health care over the next biennium. At a time when Ohio faces an opiate epidemic and tough economic times, the Senate version of the bill creates additional barriers and harm for Ohioans earning minimum wage and those struggling with drug addiction.
The most concerning provisions include language that:
- Freezes enrollment in Group VIII, commonly known as the expansion population, as of July 1, 2018. Many members of this group move above and below the upper income limit due to changes in hours, seasonal employment, etc. An enrollment freeze will cause these individuals to lose health care permanently.
- Requires The Department of Medicaid to re-submit the Healthy Ohio waiver- a waiver that was rejected by CMS in 2015. Rather than take the opportunity to build an innovative healthcare system designed to assist individuals in being healthier, the Senate chose to go forward with a previously rejected waiver.
- Requires individuals covered by Medicaid via expansion to be working or in school, unless they fall into one of three narrow exemption categories. The philosophy espoused in the language does not recognize those who are actively seeking work or those on a waiting list for an alcohol or drug treatment program. By not including those trying to turn their lives around, Ohio leaves their health care needs untreated putting them a step behind and with no choice but to end up in an emergency department, raising uncompensated costs and by extension costs on all taxpayers.
- Requires The Department of Medicaid to seek approval from the Controlling Board for funds to pay for expansion through the FY 18-19 Biennium. The General Assembly anticipates these funds will be needed to pay Medicaid costs, yet instead of an appropriation, creates a barrier for the state to conduct business and provide care to Ohioans.
The Ohio General Assembly has entered the final phase of deciding on the state budget for the next two years-and will likely finalize the budget by Monday, June 26. The current version of the budget includes language that would freeze Group VIII enrollment (AKA Medicaid expansion enrollment), starting July 1, 2018. Under this language, once you are ineligible for enrollment under expansion for any reason you can no longer re-enroll under expansion. We believe this may lead to over half of the current enrollees losing coverage in just the first year.
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The current version of HB 49 includes language that will remove healthcare access for hundreds of thousands of Ohioans over the next biennium.
As you prepare to cast a final vote on Ohio’s budget, please keep in mind the 700,000 Ohioans who are struggling to overcome chronic physical and mental health illnesses, addiction, poverty and other challenges. Medicaid expansion allows them to keep the health care that aids in overcoming those challenges while also allowing Ohio’s Community Health Centers to expand appropriate capacity, adding providers, locations, integrating additional services like Medication Assisted Treatment, and expanding hours of operation to meet community need.
Please remove the Medicaid enrollment freeze and work requirements from HB 49-give Ohioans a chance to be healthy and productive!