What rural Ohio stands to lose if proposed change to Medicaid open enrollment moves forward

People from Columbus and Ohio's other big cities may not fully understand the importance of Medicaid for rural and less-populated counties across Ohio. Medicaid, which is the second largest health insurance provider in Ohio, covers just over a quarter of our state's entire population. In many rural counties, particularly in southern and southeast Ohio, the percentage of people covered by Medicaid is significantly higher than the state average, and higher or on par with Cuyahoga, Franklin and Hamilton Counties - which are home to Cleveland, Columbus and Cincinnati.

Medicaid assists in covering rural health clinics and federal qualified health centers, prescription drugs, nursing home and home health care, and drug addiction treatment - among many other services vital to people across our state - but particularly in more rural communities.

Since Ohio expanded Medicaid in 2013, our state has seen a nearly 50% reduction in its uninsured rate. A major reason for Medicaid's success in providing quality health insurance to such a significant percentage of our population is the open enrollment process. Through open enrollment, Medicaid members can change their plan if they want to or keep it if they like it. It's a relatively straightforward, accessible process that limits confusion and works well on the large scale required to manage such a robust and complex system.

Unfortunately, in a misguided attempt to improve the Medicaid system, the Ohio Department of Medicaid is considering a modification to the open enrollment process next year that would throw a wrench in the system. The proposed change would effectively kick every Medicaid member off their plan during open enrollment and force them to re-select a plan. If they don't select a plan - rather than staying on their current plan, as it works in the current system - the government would enter them into a plan.

The unintended result would be a more burdensome process for Medicaid enrollees that would create confusion and unintended consequences, including doctor changes. Imagine someone working to overcome a drug addiction who is forced to disrupt their care, or someone with a sick child who must now find a new pediatrician. The list of harmful possibilities goes on, but ultimately the change could negatively impact health outcomes on a widespread scale.

First of all, the government should not be in the business of changing people's health care plans without their direct consent. This should be a bedrock principle of a well-functioning health care system. The proposed change would inevitably go against this principle for every single Medicaid member in Ohio who does not actively select a plan during the open enrollment process.

Secondly, while encouraging and increasing consumer choice within Medicaid is important, the current system allows any Medicaid member to change plans without forcing them into a burdensome process to reselect their current plan if they want to. While I encourage the Ohio Department of Medicaid to improve their systems and increase access, this particular alteration to the open enrollment process would be an attempt to fix a problem that simply does not exist. Making matters worse, forcing the more-than three million Medicaid enrollees in Ohio to make an active selection could cripple the enrollment system.

All too often, decision makers in Columbus forget about the needs of rural Ohioans. This time, Governor DeWine and Ohio Department of Medicaid Director Maureen Corcoran should take the time to understand the issue and ensure this change to the Medicaid open enrollment process does not go into effect. If it does, the people who Medicaid serves - including the elderly and people living in poverty or with disabilities, including many in rural Ohio - would bear the brunt of the unintended consequences.

Janalee Stock, retired RN

Athens