Disability Rights Ohio applauds Governor Kasich’s budget plan to expand Medicaid and simplify the eligibility process

February 6, 2013

A proposal to expand Medicaid and simplify its eligibility process has been included in Governor Kasich’s executive budget request for state fiscal years 2014-2015.

In 2010, Congress enacted the Patient Protection and Affordable Care Act (ACA). The law originally mandated that all States expand Medicaid to all persons with incomes under 138% of the federal poverty level (FPL), which is less than approximately $15,415 per year for a single person and less than $31,809 for a family of four. In June 2012, the U.S. Supreme Court held that state could not be required to expand Medicaid coverage; any expansion had to be optional.

As a result of Gov. Kasich’s decision to move forward with expanding Medicaid coverage up to the 138% of FPL, many more Ohioans, including people with the disabilities, will now be eligible for Medicaid and have greater access to healthcare and mental health services. The following are specific examples of how Medicaid Expansion will benefit the disability community:

• According to the Office of Health Transformation, many of the Ohioans who currently attempt to access mental health services through county boards of mental health and addiction services will become eligible for Medicaid under the expansion, allowing counties to redirect those resources for other supportive services, such as housing or employment;
• Medicaid expansion no longer requires a disability determination for eligibility purposes. This helps low-income adults who may have disabilities but do not meet the formal disability requirements of the SSI program or are forced to wait a long time before a determination is made on their case;
• Current eligibility criteria will not change for people with disabilities who are receiving Medicaid through a home and community based services waiver or the Medicaid Buy In for Workers with a Disability program.

According to estimates, approximately 500,000 to 700,000 Ohioans will gain coverage under the expansion. Moreover, the expansion will result in billions of additional federal funds flowing into Ohio’s healthcare systems, creating jobs and supporting the Ohio economy – not to mention providing critical healthcare services to many newly eligible Ohioans. Disability Rights Ohio will continue to advocate for people with disabilities to be considered for employment opportunities and job-training services.

In addition to the expansion of the Medicaid program, the budget request also includes a provision to simplify and modernize the Medicaid eligibility process. We hope this effort will result in a more timely, consumer friendly, and person-centered approach to applying for and receiving care under Ohio’s Medicaid program.

One note of caution, however: according to the Office of Health Transformation, the Kasich administration is proposing new Medicaid cost-sharing requirements for every adult earning more than 100% of the FPL. For example, Medicaid will now require an $8 copayment for inappropriate use of a hospital emergency department, $8 co-pays for nonpreferred drugs, and $3 co-pays for preferred drugs. Disability Rights Ohio will continue to examine these cost-sharing initiatives and report our findings as more information becomes available.

Now that Governor Kasich has submitted his executive budget proposal for state fiscal years 2014-2015, members of the Ohio General Assembly will begin holding hearings to examine its many provisions. If you are interested in expressing your position on any budget-related matter, now is the time to contact your state Representative or Senator.

Other online resources:

Governor's Office of Health Transformation: Extend Medicaid Coverage to Low-Income Ohioans website

Governor's Office of Health Transformation: Governor Kasich's official proposal

Health Policy Institute of Ohio: Policy considerations for Medicaid expansion in Ohio [PDF]