U.S. rejects Ohio proposal to require Medicaid premiums

Healthy Ohio Plan sought to wean able-bodied adults off the health program

9/9/2016

COLUMBUS — A state proposal to require working poor adults on Ohio’s expanded Medicaid rolls to pay more toward their health care or risk losing coverage was rejected Friday by the federal government.

The Healthy Ohio Plan would have charged Medicaid beneficiaries premiums and potentially removed them from the rolls if they missed two payments.

The governor presented his original proposal as an effort to instill self-sufficiency and wean able-bodied working adults off the program.

Opponents countered that the proposal, especially when legislative Republicans expanded on it, was mean-spirited and part of a broader effort to undermine the broader federal Affordable Care Act under which Ohio had expanded its Medicaid rolls.

The state needed a waiver from federal Centers for Medicare and Medicaid Services’ rules.

“We are concerned about the state’s request to charge premiums, regardless of income, to the 600,000 individuals in Ohio’s new adult group, as well as hundreds of thousands of low-income parents, foster-care youth, and beneficiaries with breast and cervical cancer,” Andrew M. Slavitt, the center’s acting administrator wrote in rejecting that waiver..

He wrote that the changes would have undermined the goal of expanding Americans’ access to affordable health care.

“…Ohio’s application would excluded individuals from coverage indefinitely until they pay all arrears, a policy that we have not authorized in any state…,” Mr. Slavitt wrote. The Kasich administration had estimated that 125,000 people could have lost coverage as a result.

The plan submitted to the federal government ended up being more expansive than what Mr. Kasich had originally proposed, but he signed the final budget containing lawmakers’ plans into law in 2015.

“We believe encouraging personal responsibility in health care is key to helping individuals move up and off of Medicaid, and we look forward to continuing our work with the General Assembly to achieve our mutual goal of adopting a plan that embraces this important principle,” said state Medicaid spokesman Melissa Ayers.

Gov. John Kasich had originally proposed charging a monthly premium of $20 on a population of roughly 120,000 to 130,000 people earning just above the federal poverty threshold.

By the time legislative Republicans finished with the budget, the plan had been expanded evolved to call for these enrollees to pay up to 2 percent of their annual adjusted incomes, capped at $99 a year, or $8.25 per month, into a health savings account. Medicaid would then add $1,000 to each account.

These accounts would have served as deductibles for health services before the Medicaid payments would kick in. Failure to pay two monthly premiums could kick recipients off the rolls, and coverage would not be restored until their accounts were made whole again.

“This news is a victory for working parents, foster youth, and caretakers across Ohio who would have faced unfair changes to coverage and costs under this destructive plan,” U.S. Sen. Sherrod Brown (D., Ohio) said. “Ohioans spoke out loud and clear against this plan and today’s news proves what a difference the people can make when they make their voices heard.”

Contact Jim Provance at: jprovance@theblade.com or 614-221-0496.