Ohio healthier, more prosperous with expanded Medicaid

A new report on Ohio’s Medicaid expansion gives more support for what was a controversial move by Gov. John Kasich four years ago.

More low-income Ohioans can see health-care providers regularly and more can get treatment for addiction or mental illness, helping thousands get jobs or promotions that pay enough money so that they no longer need Medicaid.

That’s just the way public-assistance programs should work: temporary aid to help people overcome barriers that prevent them from working and leading independent lives.

Of course, many of the 3 million Ohioans receiving Medicaid will need the subsidized insurance for the long term because they are disabled or elderly. That’s the original humane purpose for the joint federal/state program.

But the expansion, which was offered as part of the Affordable Care Act (Obamacare), was about extending help to those who earn too much to qualify under Ohio’s traditional Medicaid income guidelines but don’t earn enough to afford health insurance on the Obamacare exchange.

In Ohio, it meant raising the income limit to 138 percent of the federal poverty level, which made insurance available to 700,000 people who weren’t eligible before.

The results, spelled out in a report released Tuesday by the Department of Medicaid, are impressive. Most predictably, the percentage of Ohioans without health insurance plummeted from 17.3 percent in 2014, when the expansion took effect, to 9.3 percent in 2017.

Looking at those who enrolled in Medicaid under the expansion and have since disenrolled, 71 percent did so because they got jobs with health insurance or saw their earnings rise enough to disqualify them.

Most of those who remain on the rolls via the expansion said the Medicaid coverage made looking for and keeping a job easier. Some were able to get surgeries they needed to be healthy; others finally were able to get treatment for chronic conditions such as diabetes.

Nearly 26,000 said they used Medicaid smoking-cessation programs to quit smoking, and 96 percent of those expansion enrollees with an opioid-use disorder received treatment.

These benefits come at a reasonable cost to Ohio taxpayers because the federal government pays a greater share of the cost for Medicaid expansion enrollees than those in the traditional program — currently 93.5 percent, compared with 63 percent.

Under Obamacare terms, the feds’ share of the expansion cost will drop to 90 percent in 2021 but is not projected to go any lower. Ohio’s 10 percent share that year is projected to be $517.2 million, but state budget director Tim Keen says the actual cost is lower.

Because the expansion saves the state money via health care for prisoners, higher-volume drug rebates and other areas, Keen says, the state’s net cost for expanding Medicaid is $163.1 million — equivalent to 3.2 percent of the full cost.

Kasich angered many in his party by pushing for Medicaid expansion, even resorting to some bureaucratic sleight-of-hand to bypass the General Assembly and enact it via the state Controlling Board. He continues to take heat from ideological conservatives who oppose any expansion of government and any complicity with the Affordable Care Act, no matter how much it benefits Ohioans.

That argument will be Kasich’s to wage in his political career beyond the Statehouse. For those interested in helping Ohioans make their way out of poverty, facts show that the Medicaid expansion is a success.
 
 
Editorial Board, The Columbus Duspatch, August 23, 2018
Ohio healthier, more prosperous with expanded Medicaid