“Medicaid Expansion’s Potential Impact on Health Disparities” by Julie Merker

In February 2013, Governor John Kasich became one of only 8 Republican governors to include Medicaid Expansion[i] in the state budget. This notable change would allow ALL adults under 65 and below 138% of the Federal Poverty Level (FPL) to be eligible for Medicaid health care coverage. This is a boon for health care advocates since it could mean providing insurance coverage for an estimated 700,000 economically vulnerable Ohioans.

Recently, however, the Ohio House of Representatives stripped the budget of straight Medicaid Expansion language. In its place, an amendment dubbed The “Ohio Plan[ii]” has been introduced. The “working poor” would be directly impacted by the Ohio Plan, as it is targeting people making 100% – 138% of the FPL.  The significant difference from the standard federal Medicaid Expansion is that these newly eligible consumers would be enrolled in private insurance markets rather than in the traditional Federal-State Medicaid Program. Governor Kasich believes that the government should not substitute a public option for something that can be handled in the private sector.

What would any degree of Medicaid Expansion mean for the vulnerable members of our communities? Advocates for health care reform proclaim benefits on all levels:

·       Federal:  The Centers for Medicare and Medicaid Services[iii] (CMS) has initiated a collaboration among various partners to address the issue of health disparities in the United States. CMS is actively collecting data on enrollees in an effort to disseminate information and best practices to eliminate health disparities.

·       StatePolicy Matters Ohio[iv] reported in 2012 that Ohio ranks 42nd in “Healthy Lives” statistics and has very high per-person health care costs. Medicaid Expansion could thus improve Ohio’s overall health record in relation to other states.

·       Local: Economic benefits[v] from 2014-2022 include an estimated employment increase of 23,000-28,000 jobs. Social benefits[vi] include the ability of local boards to reinvest state and local funding in non-Medicaid endeavors such as housing and employment services.

·       Individual:  Medicaid Expansion means increased access[vii] to preventative care; fewer costly trips to the Emergency Department to treat preventable and chronic conditions; and access to mental health and addiction services.

While Medicaid Expansion alone will not cure us of health disparities, it is a step in the right direction.

[i] UHCAN Ohio – Frequently Asked Questions – Medicaid Expansion http://uhcanohio.org/sites/default/files/FAQs%20Medicaid%20expansion%2011-7-12.pdf

[ii] Ohio’s Medicaid expansion alternative could use private insurance http://www.cleveland.com/healthfit/index.ssf/2013/04/ohios_medicaid_expansion_alter.html

[v] Expanding Medicaid in Ohio: Fact Sheet: The impact of not expanding Medicaid in Ohio http://a5e8c023c8899218225edfa4b02e4d9734e01a28.gripelements.com/pdf/publications/notexpandingmedicaid_onepagefactsheet.pdf

[vii] What Behavioral Health Advocates Need to Know about Medicaid Expansion http://uhcanohio.org/sites/default/files/OCHC%20and%20OCA%20ME%20Friday%20webinar%20FINAL.pdf