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A Note from the General Manager about Excursions

Another Battle Is Brewing Over Ohio’s Medicaid Expansion

The expansion of Medicaid to previously uninsured Ohioans began in January and has given nearly 340,000 residents health coverage. But the program's long-term success is also uncertain, as the political battle over Medicaid expansion in Ohio is about to begin round two.

In late 2013 Governor John Kasich circumvented the Republican-led legislature to pass Medicaid expansion through his own Controlling Board. The expanded funding for the low-income health care program is a provision of the Affordable Care Act that about half the states chose not to take up.

The expanded eligibility covers all adults ages 18-65 making 138 percent of the federal poverty level or less; since the law’s inception in Ohio, expanded Medicaid has covered many more people than plans purchased through the ACA exchange, which only provides subisides for people making one to four times the federal poverty level.


But all that could go away.

“July of next year, if there is no intervention, Medicaid expansion in the state of Ohio disappears,” said University Hospitals’ Chief Executive Tom Zenty at a recent forum in Cleveland. Zenty went on to warn that hundreds of thousands of poor adults in Ohio could lose health coverage in less than 12 months.

That is the outcome Rea Hederman Jr., chief operating officer at the conservative Buckeye Institute, would like to see.

“We are very much against continuing Medicaid expansion,” he said. “We think that there is a better way to offer care to these people.”

Hederman says Ohio should drop expansion and possibly provide coverage in a different way. He suggests the state might opt for a set-up like Indiana, which attaches extra requirements for people enrolled in the program.

Medicaid is “up in the air” because Governor Kasich never actually won approval from state lawmakers to expand it. The executive action he took to get around opponents was only a temporary solution, and issue will go before the legislature next year.

Lewis Wallace contributed to this report.