In January, 2014, Ohio implemented a traditional Medicaid expansion, according to the terms set out in the Affordable Care Act. Subsequently, the operating budget passed by the state legislature in June, 2015 required Ohio to seek specific changes to its existing expansion by applying for a Section 1115 demonstration waiver. On June 15, 2016, the state submitted its waiver proposal, called the Healthy Ohio Program, to the Centers for Medicare and Medicaid Services (CMS), and on September 9, 2016, CMS denied the waiver application.
This is the first time that CMS considered a waiver application in a state that already had implemented a traditional expansion and the first time that CMS has denied a Medicaid expansion waiver application. Waiver applications in other states that already have implemented traditional expansions (Arizona and Kentucky) remain pending with CMS. CMS’s decision about Ohio’s waiver application may offer insights into how the agency might respond to similar requests from …
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CMS’s Denial of Proposed Changes to Medicaid Expansion in Ohio