A proposal to extend Medicaid coverage to Ohio’s working poor was introduced Wednesday in the Ohio House, but it may be just the first of many plans yet to come.
The bill introduced by Republican Rep. Barbara Sears of Lucas County is in some ways similar to what Gov. John Kasich proposed in his budget in February.
Like the governor’s proposal, it would expand coverage for Ohioans earning up to 138 percent of the federal poverty level.
But Sears’ legislation also requires the state to study reforms that could lower costs and reduce uncompensated care. And it calls for job training services meant to help Medicaid recipients find better jobs that have health coverage of their own.
The legislation also includes a way out for Ohio that could assuage some Republican concerns that promised federal funding could be cut.
The Patient Protection and Affordable Care Act provides that the federal government would cover all the costs of newly eligible enrollees for three years and then 90 percent in future years.
Analysts have predicted that Ohio could actually come out ahead from the expansion, with its $13 billion in Medicaid funding.
Kasich has also argued Ohio should do it because it is the right thing to do.
The plan met resistance from some of Kasich’s fellow Republicans and was stripped from the budget package while debated in the House. Conservative House members had said they didn’t like the expansion of the government health program, feared it could expand the national debt and didn’t trust the government to live up to its funding pledge.
That last point was a concern often heard. What would Ohio do if federal assistance were to be cut after it had expanded the program?
Sears’ bill calls for Ohio’s Medicaid program to cease coverage for the expanded group if certain funding reductions occur.
The bill also includes specific provisions meant to “reform Medicaid,” a phrase that has grown in use around the Statehouse as legislators debate ways to extend coverage without labeling it as a program expansion.
The state’s Medicaid director, for example, would be required to report to the General Assembly on progress made toward reforms — measures that leverage the state program’s purchasing power or safeguards to bolster efficiency and reduce cost.
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