Neither is the State of Ohio.
My colleagues and I are currently working on the next two-year operating budget. Medicaid Expansion, otherwise known as Group Eight, has become a politicized debate.
Now an even bigger challenge looms.
Governor DeWine’s budget proposal included what is called a ‘trigger clause’ concerning Group Eight. Before I explain what that means, it’s important to understand how the Medicaid program was expanded.
Historically Medicaid covered adults earning below 100% of poverty the line, everyone who is disabled, and every child living at 200% below poverty.
The federal government covered about 65% of the cost.
In 2014, Governor Kasich bypassed the authority of The General Assembly and was able to expand the program with a controversial vote of the Ohio Controlling Board.
The General Assembly did not support the expansion for fear of the exact scenario the taxpayers are facing today.
The Medicaid expansion or Group Eight covered everyone between 100% to 138% of the poverty line, but the federal government covered 90% of the cost.
This added about 700,000 Ohioans to Medicaid.
The ‘trigger clause’ basically states that if the federal government at any time decreases its 90% share of the cost, The State of Ohio “shall immediately discontinue” the expansion program.
The narrative from my colleagues on the other side of the aisle and special interest groups, call it mean spirited that the State of Ohio would even consider removing automatic health coverage for 700,000 Ohioans.
You know as well as I do, that when you make your budget at the kitchen table, there are things you fund and things you don’t. You might tell your children that you’d love to buy them a used car for college, but instead, you can’t afford another car payment, and if they want that used set of wheels, they’ll need to go to work to help pay for it.
Right now, the federal government pays approximately $7.5 billion, and Ohio’s share is about $838 million.
If the federal government returns to Ohio’s normal reimbursement of 65%, the state will have to spend an additional $2.2 billion to cover the cost.
The General Assembly and Governor DeWine would have to make very difficult decisions about where to cut spending. Just like your budget at home, everything would be under review.
The discussion in Washington is that there will be changes to Medicaid at the Federal level. We don’t know yet what those changes will be. Ohio needs to prepare now by assuring that the ‘trigger clause’ is there to protect your tax dollars.
Here is the diagnosis. Medicaid cannot survive at this current level of spending. It is out of control. In fact, Governor DeWine’s budget increased spending for Medicaid by 12%. The U.S. inflation rate for the cost of healthcare is 3%.
The Biden Administration repealed Ohio’s work requirements for coverage, but if the Group Eight program remains, we hope the Trump Administration reapproves them. There are exemptions of course, including those suffering from serious physical or mental disabilities or addiction.
Bottom line, people have options with or without Group Eight. Healthy people could explore the job market for full time employment with benefits, others might receive coverage elsewhere within Medicaid, or they could turn to the federal healthcare portal.
Despite what you may hear from the left, Medicaid is not going away.
State Sen. Steve Huffman, R-Tipp City, chairs the Senate’s Health Committee and is a practicing emergency room MD.
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