Work Rules Approved For Ohio Medicaid Expansion

Ohioans who are covered by the expansion of Medicaid will soon have to get a job, go to school or get an exemption.

The U.S. Centers for Medicare and Medicaid Services gave Ohio approval Friday to impose work requirements for those covered by Medicaid expansion.

The health insurance program for low-income Ohioans is jointly funded by the state and federal government. The state lists about 540,000 covered through Medicaid expansion as of February.

"I am pleased that Ohio is a model state that balances a pathway to employment and access to health care in our reasonable work requirements. They are intended to put those able-bodied adults served by the Medicaid expansion on a pathway to full employment," Gov. Mike DeWine said in a statement.

Work requirements have been hailed by some conservative lawmakers as a way to encourage self sufficiency. Critics of the move have said work requirements are an unnecessary burdens on the poor, will make health outcomes worse, and waste money on red tape.

"According to the State of Ohio's own extensive, independently conducted research, Ohio's Medicaid program enabled hundreds of thousands of Ohioans to get and stay healthy. Healthy Ohioans can keep their jobs and take care of their families without fear of choosing between their health and other necessities like food or rent," John Corlett, former Ohio Medicaid director and executive director of the Center for Community Solutions.

He said the state needs to monitor how this change impacts the economic viability of safety net hospitals, community health centers and community mental health centers that serve a large percentage of Medicaid patients.

Ohio requested federal permission to create work requirements under the direction of the Republican-majority Ohio General Assembly during former Gov. John Kasich's administration.

The state had estimated that about 95 percent of those covered by the expansion would already either meet the work requirement or be exempt. Some of the exemptions include being age 50 years or older, participating in drug or alcohol treatment, being pregnant, or complying with work requirements associated with other programs like SNAP, also known as food stamps.

Center for Community Solutions has questioned the math of how many people will lose coverage, pointing to when the state implemented work requirements for SNAP benefits. While the state estimated 134,000 recipients would be affected, nearly 400,000 Ohioans no longer receive SNAP benefits.

Dayton-based CareSource, which privately manages Ohio Medicaid plans, had grown when the program was expanded.

Steve Ringel, president of Dayton-based CareSource, said in a statement that the company "looks forward to partnering with the state to support work requirements and the community engagement waiver." He highlighted that CareSource had previously developed a program called JobConnect, which connects its Medicaid members to one-on-one coaching and support with seeking employment and education.

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