Ohio Moves Forward with Medicaid Expansion

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Ohio has decided to move forward with an expansion of Medicaid under the Affordable Care Act. From The New York Times:

With Monday’s vote, Ohio became the 25th state plus the District of Columbia to expand Medicaid, according to the Kaiser Family Foundation. Nearly a dozen Republican governors have moved to do so, despite the efforts of Congressional Republicans to “defund” the health care law.

Governor Tom Corbett has proposed a plan that would take up the federal option to expand Medicaid health coverage to individuals who would be newly eligible under the Affordable Care Act. His plan would depart from the federal law's vision of Medicaid expansion by using private health insurance plans to deliver the coverage. It also institutes new requirements for all Medicaid enrollees, including monthly premiums and work search requirements, that could make it more difficult for people to access health coverage. The federal government must approve the plan before it can go forward.

Two recent studies are critical reminders that Pennsylvania cannot afford to turn down federal funding that states like New Jersey and Ohio will use to insure their citizens next year.

First, the Hospital and HealthSystem Association of Pennsylvania (HAP) released a report last week showing that the percentage of uninsured Pennsylvanians increased from 10.8% in 2011 to 12% in 2012 — despite uninsured rates declining nationally over the same period. The Pittsburgh Post-Gazette reported on the study:

"We continue to see a dangerous erosion of employer-based coverage," said Andy Carter, president and CEO of the Hospital and Healthsystem Association that represents the interests of nearly 240 health facilities.

"The number of Pennsylvanians covered by private, employer-based plans hit an all-time low of 59.5 percent in 2012," he said.

And that's not solely because people are out of work, he added.

"Three out of every 4 uninsured Pennsylvanians live in a household with at least one working adult, and nearly 4 out of 5 live in Pennsylvania's suburban and rural regions," Mr. Carter said.

The HAP study came on the heels of a report from the Kaiser Family Foundation that found if Pennsylvania fails to expand Medicaid next year, 281,290 uninsured adults in the commonwealth will fall into a "coverage gap." These uninsured adults, with incomes below the federal poverty level but too high to qualify for the state's existing Medicaid program, are ineligible for subsidies to purchase private coverage on the Health Insurance Marketplace created by the Affordable Care Act. The Kaiser researchers explain:

The ACA envisioned people below 138% of poverty receiving Medicaid and thus does not provide premium tax credits for the lowest income. As a result, individuals below poverty are not eligible for Marketplace tax credits, even if Medicaid coverage is not available to them. Individuals with incomes above 100% of poverty in states that do not expand may be eligible to purchase subsidized coverage through the Marketplaces; however, only about a third of uninsured adults (3.2 million people) who could have been eligible for Medicaid if their state expanded fall into this income range. Thus, there will be a large gap in coverage for adults in states that do not expand Medicaid.

Time is running out and Pennsylvania taxpayers cannot afford to miss the January 1 start of expanded Medicaid health coverage. If we don’t expand coverage in 2014, hundreds of thousands of working families will be left without coverage for another year, and everyone will pay the price for prolonging the cost of uncompensated care.

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