Medicaid’s complicated history continues to make it a battleground topic in both federal and state governments. Because regulations for this healthcare system are set by the federal government but implemented based on state legislative decisions, the availability and options for healthcare coverage vary greatly from state to state. Some states embrace Medicaid expansion wholeheartedly while others continue to oppose it. Ohio is one state that has embraced Medicaid, even if not as thoroughly as other states have.
Current State of Medicaid In Ohio
Ohio has expanded Medicaid through the Affordable Care Act (ACA), which is not surprising considering that it first enacted Medicaid in 1966. This means that adults who live with an income up to 138 percent of the federal poverty line (FPL) are eligible for coverage, as are children up to 211 percent and pregnant women up to 205 percent of the FPL. Ohio is also a state that relies on a federally facilitated exchange for other kinds of private healthcare plan enrollments, but as of October 2019, 21 percent of the 11.3 million residents of Ohio were covered by Medicaid/CHIP.
Medicaid expansion through the ACA has resulted in a large number of Ohioans becoming eligible for healthcare, at an increase of almost 600,000 people between 2013 and 2018. The expansion population now includes over 700,000 people. Numbers have tapered off since then, however. How enrollment rates continue will depend on what lawmakers decide to do with Medicaid in the near future.
Expanding the ACA has not just increased the number of people enrolled in Medicaid. The decision to allow a federally facilitated exchange for private plan enrollment has allowed hundreds of thousands of Ohioans to become insured without Medicaid (almost 197,000 from the 2020 enrollment period, which is actually a lower number than in previous years). These numbers combined with those of Medicaid result in approximately 6.5 percent of the population being uninsured (as of 2018).
Medicaid has enjoyed decently bipartisan support in Ohio in recent years, with many previously anti-ACA legislators softening their positions on it. As a result, Medicaid has a steady presence in Ohio, with the main factor in its change being extra legislation and waivers that Ohio has been working to push through and implement in recent years.
One of the most common battleground issues recently among states when it comes to the topic of Medicaid is if and how work requirements should be implemented. Ohio is no exception to this debate. In March 2019, the federal government approved Ohio’s work proposition, which requires most Medicaid recipients to work a minimum of 80 hours per month in some constructive pursuit, whether that be schooling, volunteer work, a part-time job or other program. However, part of the reason why this requirement has been approved is that over 60 percent of people eligible for or receiving Medicaid benefits are already working in this way. Many others who are not working are exempt due to disability status, caretaker status, age (50+) and other conditions in which they are physically unable to perform constructive activity.
It is to Ohio’s credit, too, that a vast majority of people say that being covered by Medicaid has improved their ability to find and hold down jobs. The main downside to this work requirement is that there is a significant number of the Medicaid-covered population that could lose access to care when it finally goes into effect (about 18,000). This will be an element of Ohio Medicaid worth keeping track of when it goes into effect.
How DECO Can Help
We know Medicaid and how to navigate its complicated systems and regulations. At DECO, we are knowledgeable and experienced in the area of healthcare coverage and finance, and we can help your healthcare organization improve its revenue cycle management system. Our team advocates for uninsured patients to become insured by Medicaid and other programs, and we go above and beyond to help your organization become financially stable. For more information, contact us today!