Medicaid expansion divisive

State senator: Policy could save Ohio money

8/14/2013

COLUMBUS — Projections showing that Ohio could save state and federal dollars by expanding Medicaid are just one part of a fact-finding process for state lawmakers debating changes to the health program, a key Republican lawmaker said Tuesday.

State Sen. Dave Burke, who chairs a Senate Medicaid subcommittee, said the recent analysis indicates that curbing Medicaid’s cost growth to a certain rate is feasible, even when more people are enrolled.

“Crafting policy about how we get there is where the cantankerous issues come up,” said Mr. Burke, of Marysville.

State lawmakers have been trying to find common ground on Medicaid since Republican Gov. John Kasich proposed an extension of the federal-state program in February. GOP leaders pulled it from the state budget, and the issue has yet to gain traction in the legislature.

Some Republican legislators say they fear being stuck with long-term costs of Medicaid expansion and are leery of expanding government programs.

Mr. Burke and Democratic Sen. Capri Cafaro asked the Health Policy Institute of Ohio to compare Medicaid spending without expansion at its current growth rate, with spending that could occur under the expansion at a yearly rate that’s similar to an average cost of medical inflation.

Without expansion, total Medicaid spending in Ohio is projected to reach $43.4 billion in 2025 at its current rate of 7.2 percent per year. With extended coverage and the Medicaid growth rate maintained at 3.5 percent per year, spending could be $37.2 billion in 2025, according to the analysis by the health policy organization and Ohio State University’s John Glenn School of Public Affairs.

Mr. Burke said the analysis shows it’s possible to lower federal and state costs with expansion if the right policy is written. But he added that one set of numbers doesn’t make a trend.

“Let’s have some other people tear this apart,” he said. “Let’s have a lively debate before we make a decision.”

The Senate Medicaid subcommittee will travel to Cleveland next week to see how a mini-Medicaid expansion model works. The panel also will meet with a managed care organization in Dayton.

Medicaid expansion is one of the key components of Democratic President Obama’s health-care law.

Roughly 366,000 Ohioans would be newly eligible for coverage beginning in 2014 by expanding Medicaid. The federal-state health program for the poor already provides care for one of every five residents in the state. Washington would pay the entire cost of the expansion for the first three years, gradually phasing down to 90 percent — still above Ohio’s current level of almost 64 percent.