Local agencies endorse Medicaid expansion

Opponents worry Ohio will get stuck if feds don’t keep promises.

In Clark County, that figure could be about 8,000 to 9,000 additional residents, according to information from the Clark County Department of Job and Family Services. Overall in Clark County, about 34,000 residents are enrolled in the program now.

The plan, proposed by Ohio Gov. John Kasich, would make health coverage available to as many as 275,000 low-income Ohioans, said Mark Davis, president of the Ohio Provider Resource Association. The organization is a statewide association of service providers for residents with developmental disabilities.

“They see it being in the best interests of their state and their citizenry,” Davis said.

Kasich is one of about eight Republican governors who supports expanding the program, which was included as an option under President Obama’s Affordable Care Act. Supporters have said expanding the program will also help ensure federal tax dollars are spent in Ohio, help prevent a $400 million budget hole in the state budget and help private entities provide health insurance to their employees.

However, the plan has also drawn scrutiny among some state lawmakers and raised concerns that Ohio could get stuck with a bill it can’t afford if the federal government backs out on promises that it would fully fund the program for the first three years and pay as much as 90 percent of the cost for years beyond that.

The program would be expanded to adults earning up to 138 percent of the federal poverty level, about $15,400 for an individual and $31,800 for a family of four.

Without the expansion, Champaign Residential Services Inc. would likely have to reduce employee hours to avoid paying a penalty because it cannot afford insurance for many of its employees under the Affordable Care Act, said Than Johnson, CEO of CRSI. The agency, whose headquarters is in Urbana, is a private agency that offers services to individuals with developmental disabilities across 30 Ohio counties. CRSI hosted the forum Friday.

But reducing hours could potentially lead to more inconsistent care for patients, a situation Johnson said could be alleviated if the Medicaid expansion moves ahead.

Kasich faced a difficult decision, said John Martin, director of the Ohio Department of Developmental Disabilities. Although Kasich did not support the Affordable Care Act, he ultimately decided not expanding the program would leave almost 300,000 Ohioans without coverage. Expanding the program would also help protect hospitals from budget cuts and help strengthen mental health and addiction services statewide, Martin said.

“That’s a moral issue,” Martin said.

Expanding Medicaid with federal dollars could have short-term benefits, said Greg Lawson, a policy analyst with the conservative Buckeye Institute. But it could also leave Ohio on the hook for an increasingly expensive program if the federal government ever backs out on its promises. Although estimates show 275,000 Ohioans could apply under the expansion, that figure could possibly be much greater.

“The truth is no one really knows with any certainty what that expanded population would be,” Lawson said.

Along with questions on whether the expansion is sustainable, Lawson said the state could make changes to the Medicaid program so it could be run without federal assistance.

“We don’t think this is a binary choice where you want to help people with low income or you don’t,” Lawson said.

However, expanding Medicaid would assist not only the state’s poorest residents, but many of the working poor who help provide services to residents with disabilities statewide, said Jenny Rouscoup, superintendent of Developmental Disabilities of Clark County. Her agency has been able to retain its staff at a much better rate than many others across the state simply because it is able to provide health insurance as a benefit, she said.

Susan Bailey-Evans, director of the Champaign County Department of Job and Family Services, said the expansion will likely lead to a significant demand on her staff as more residents seek eligibility to the program. However, she said the state is now looking for ways to simplify that process.

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