Medicare expansion fight still looms

Thousands in Clark County would qualify for benefits under plan.Springfield lawmaker says any changes must make financial sense.

Thousands of low-income Clark County residents would get health care coverage if state lawmakers expand Medicaid, but some officials question whether it will become a financial burden to the state.

Under the proposal, benefits would be extended to about 366,000 uninsured Ohioans, including 6,131 uninsured people in Clark County between the ages of 19 to 61 years old. The program would cover those who earn up to 138 percent of the federal poverty level.

The expansion of Medicaid to adults earning $15,415 or less a year would cut the number of Ohio’s uninsured by about 457,000 by 2022, while generating about $13 billion in federal spending over the next seven years, according to Gov. John Kasich’s budget.

State Rep. Ross McGregor, R-Springfield, a member of the finance committee, said he supports reforming Medicaid in a responsible way that includes an expansion component. But he said he worries about the financial burden on the state.

The federal government has committed to covering 100 percent of the cost of expansion during the first three years beginning in 2014, then gradually reducing its contribution to 90 percent by 2020. McGregor and others, however, are skeptical.

The proposal includes an opt-out component that would shut down the expansion if the federal government does not provide the funding.

“Anything we were to do has be to clear that, if the money dries up, that it’s going to stop,” McGregor said.

Kimberly Hammett of Springfield suffers from severe heart problems, but with no health insurance survives on an outdated pacemaker to survive.

Hammett, 34, said she has been denied Medicaid three times, has been forced to file bankruptcy and cannot afford to buy a new pacemaker or pay for other medical procedures she needs.

“It’s very frustrating,” Hammett said. “It’s scary because I’m worried about the batteries to my pacemaker dying.”

Hammett, along with about 100 others, attended a rally in downtown Springfield last week in which local leaders pushed for state lawmakers to expand Medicaid.

The event was co-hosted by the National Alliance on Mental Illness and the Mental Health & Recovery Board of Clark, Greene & Madison Counties. It was one of eight events held across the state in support of the expansion.

McGregor said he’s not philosophically against the expansion, but he wants it done right.

“There’s a responsible way to do this, but just throwing money at it is not responsible,” McGregor said.

The proposal has the support of state Democrats, area mental health and other social services organizations and hospitals.

Kent Youngman, CEO of the Mental Health & Recovery Board of Clark, Greene & Madison Counties, said Medicaid expansion would help thousands of local low-income residents get access to health care and boost funding for behavioral health service providers.

Youngman said if Medicaid is expanded, his organization could save an estimated $2 million that could then be used to help others.

“About 75 percent of funds we have locally are now through local levies. We have a certain amount of money that we have available in each county, and through that, all of the non-Medicaid services that we help support have to be paid from that, so it’s not only direct care, but it’s things like support services, housing, assisting with transportation, helping with jobs,” Youngman said.

Youngman also said state funds for the mental health and recovery board have been cut by $3 million and has forced officials to turn people away.

“Our capacity to serve folks has gone down about 1,200 people within our region that we used to be able to provide services to that we no longer can because the dollars have just shrunk,” Youngman said.

Youngman said people with severe mental illness typically qualify as disabled and are Medicaid eligible, but those who struggle with drug and alcohol addiction are often out of luck as they tend to have the smallest number of people who are eligible for Medicaid.

If Medicaid expands, some state funding could return to local agencies, Youngman said.

McGregor said a “straight” expansion would take up about 53 percent of the state budget and there needs to be a way examine the effectiveness of the program.

“If we’re going to spend half or over half of the state budget on one single item, I think it’s only wise that we make sure the system is producing results,” McGregor said.

Ohio Office of Budget and Management Director Tim Keen, Kasich ’s budget chief, said earlier this month he’s optimistic a proposal to expand health coverage will re-emerge by the end of the year either as part of the budget or as a standalone bill.

It’s believed an eventual plan could involve using the federal money to purchase private insurance, a move that would require federal approval.

Keen acknowledged House Republicans’ and others’ concerns about accepting federal money. But he said failure to expand Medicaid will cost the state $500 million and also will cost employers who otherwise face federal penalties for their uninsured workers.

“The ability of the state to draw $13 billion over the next seven years to Ohio in the governor’s view is good for the health care system, good for the hospitals and, frankly, good for the economy,” Keen said.

Bill Yeazell, a Springfield man who suffers from schizo affective disorder, anxiety and other mental health issues, has been on Medicaid for years.

He earns about $1,000 per month washing windows and can only work 27 hours per week at $8 an hour because of limits placed on Medicaid recipients.

Yeazell, who ran a business for 24 years before an accident in 1996, said he was unemployed for two years and struggled to find work that meet the limitations.

He said many who need health care are often denied the benefits multiple times and have to get an attorney before they can become Medicaid eligible. But he said those on Medicaid are struggle.

“Getting on Medicaid is like riding an elephant. It’s almost impossible to get on, and it’s equally impossible to get off,” Yeazell said.”

Staff Writer Andrew Tobias contributed to this story.

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