AHCA Would End Ohio’s Medicaid Expansion, Threatening Coverage for 723,000

COLUMBUS, Ohio, June 7 -- Policy Matters Ohio, a 501(c)3 non-profit and nonpartisan state policy research institute, issued the following news release:

The health bill passed by the U.S. House of Representatives last month would effectively end Medicaid expansion by shifting costs to the 32 states that adopted the program, including Ohio. A new report from the Center on Budget and Policy Priorities (CBPP) shows the Senate's proposal to phase in higher costs to the states will still produce the same result: millions of Americans will lose coverage.

Under the Affordable Care Act (ACA), states were given the option to extend Medicaid eligibility to any resident whose income fell under 138 percent of the federal poverty line (or $33,948 for a family of four). The federal government currently pays 95 percent of the cost of care for the newly-eligible, and Ohio pays the rest. Under the House-passed American Health Care Act (AHCA), the federal match for Medicaid expansion falls dramatically, and by 2020, Ohio will have to pay an additional $871.6 million to maintain coverage for enrollees.

Currently facing an overall budget deficit of more than $800 million, these costs will almost certainly be beyond Ohio's reach, leaving the 723,000 Ohioans who have gained Medicaid coverage under the expansion at serious risk of becoming uninsured. Fewer than 5 percent of Medicaid expansion enrollees can expect to remain in the program by 2024 under the AHCA, according to the CBPP report.

"It doesn't matter if you end the Medicaid expansion quickly or slowly," said Wendy Patton, Senior Project Coordinator at Policy Matters Ohio. "The bottom line is that Ohio gets hit with massive costs, and hundreds of thousands of Ohioans will lose access to the health coverage they need."

Medicaid expansion states like Ohio have seen sharp declines in uninsured residents, improved ongoing treatment of chronic conditions, reduced costs to hospitals for treating uninsured patients and increased financial security among expansion enrollees. Under expansion, Ohio's rate of uninsurance among low-income residents dropped to 14.1 percent, the lowest rate in recorded history.

Opioid overdose fatalities in Ohio increased by more than 25 percent in 2016, and are projected to spike to 775 in Cuyahoga County alone this year, according to a report put out this week by the New York Times. Many of Ohio's health care providers and state officials say Medicaid expansion is one of the state's most powerful tools for getting people struggling with addiction into treatment. Expansion allowed 500,000 previously ineligible Ohioans to access mental health and substance abuse treatment. Among expansion enrollees facing opioid addiction, 75 percent reported better access to overall health care and 59 percent better access to mental health services.

The House bill contains tax credits for low-income people to purchase private coverage on their own, but a CBPP report shows the credits fall short. Even with the credits, premiums for Ohioans in poverty would amount to 10 percent of percent of income for 45-year olds and 48 percent for 60-year-olds. This doesn't account for provisions in the House bill that let insurers return to charging exorbitant premiums for people with pre-existing conditions, imposing caps on coverage and refusing to cover critical services like mental health services and substance use treatment.

"Senators Portman and Brown must stand up and reject any health bill that ends the Medicaid expansion, no matter the timing," Patton said. "Anything less would threaten the historic gains in health coverage and access to care that we have achieved under Medicaid expansion."

Download cbppmedicaidpr.pdf (https://www.policymattersohio.org/files/news/cbppmedicaidpr.pdf)