Gov. John Kasich says the health coverage has helped thousands of Ohioans get needed care at a reasonable cost.
In his final months in office, Gov. John Kasich sought on Tuesday to shore up support for his signature Medicaid expansion, arguing that the health coverage has helped thousands of Ohioans get needed care at a reasonable cost.
“It is affordable now, (but) if the federal government plays games and tries to put us in a perilous fiscal position, we will have to change this position on Medicaid expansion. There is no way that we can put our state deep in the hole and wreck economic development and more prosperity,” Kasich warned at a press conference in Columbus.
While the federal government pays 63 percent of traditional Medicaid costs, the federal match is 93.5 percent for expansion costs, phasing down to 90 percent in 2021, amid ongoing rumblings that Ohio lawmakers and Washington Republicans could try to dismantle the four-year-old program as financially unsustainable.
“Medicaid expansion is manageable and affordable now and into the future — $163 million allows us to leverage $5 billion in healthcare services for 653,000 Ohioans,” said state Budget Director Tim Keen.
Keen projected the state’s 10 percent share will be an estimated $517.2 million in 2021, but that drops to 3.2 percent, or $163.1 million, when including drug rebates, managed care and insurance tax revenues and other money the state receives.
In addition to the fiscal analysis, state officials released a new report crediting Medicaid expansion with reducing the uninsured rate, helping low-income residents find work and providing more access to mental health and addiction services.
The 2018 Medicaid Assessment, commissioned by the state, gave largely glowing reviews to expanding eligibility to poor, working-aged adults without dependent children. Among the findings:
• 290,000 former expansion beneficiaries, or 71 percent, left the rolls because they found a job or were earning more money.
• About half of all enrollees — 630,000 beneficiaries — have received treatment for mental illness or substance abuse.
• Ohio’s adult uninsured rate, although up slightly since 2015, has still dropped by nearly half since 2012, to 9.3 percent.
“This is about putting ourselves in someone else’s shoes. Think about what your life would be like if you couldn’t get any health care,” Kasich said after several beneficiaries shared their personal stories.
Brenda Searcy, 55, of Westerville, went without insurance for years while caring for her elderly father before qualifying for Medicaid four years ago.
“I’ve always been really healthy, but I got Lyme disease in 2015 which I was able to get quickly diagnosed and treated before it became a big problem, and last year, in a routine physical, I found out I had Graves’ disease which had just started. It is not typically found early and because of that, now I’m totally well,” Searcy said.
With health insurance no longer a worry, Searcy recently enrolled in law school.
“It’s working from an improvement of health (and) it’s working because it’s helping people work,” said Medicaid Director Barbara Sears.
The tax-funded Medicaid program provides health insurance to about 3 million poor and disabled Ohioans, including about 665,000 made eligible under the 2014 expansion under the Affordable Care Act, or Obamacare. Since 2014, more than 1.2 million Ohioans have gained coverage at one time or another through expansion.
The expansion extended coverage to adults ages 18 to 64 with no dependent children and incomes up to 138 percent of the federal poverty level, or $16,750 a year. (Children, parents and the disabled were already covered.)
The survey found that nearly half of expansion enrollees reported having a job, up 6.4 percent from 2016, when an initial analysis was conducted.
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In addition, 26,000 enrollees said they quit smoking through a cessation program provided by Medicaid.
Most beneficiaries reported increased use of primary care, likely contributing to a decline in more expensive hospital emergency room visits. Emergency room use dropped 17 percent among those enrolled two years or more, a $52 million savings.
The survey of more than 5,800 expansion beneficiaries was conducted by the Ohio Colleges of Medicine Government Resource Center.
Ohio is among 33 states and the District of Columbia that have adopted Medicaid expansion.
Cheri Walter, chief executive officer of the Ohio Association of County Behavioral Health Authorities, said “Medicaid expansion has had the single biggest impact on individuals with an addiction, (allowing) hundreds of thousands of individuals who have an addiction to get the health care that they need to help them recover.”
“If we would lose Medicaid expansion, Ohio would see all of the progress we have made on this opioid epidemic, where we are saving thousands of people now yearly, we would see many of those people lose their coverage, lose their opportunity for treatment, and we would see the number of deaths from overdoses increase.”
The report does not address work requirements, but Medicaid expansion beneficiaries may soon need to find a job or face the loss of coverage. At the direction of Republican lawmakers, some of whom have tried for years to end or significantly curtail the expansion, state Medicaid officials recently asked federal regulators to impose work requirements on most non-disabled adults.
Medicaid officials say most meet the work requirement or would be exempt, but critics argue that thousands of vulnerable Ohioans would lose coverage.
ccandisky@dispatch.com
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