Source: Office of Health Transformation
On September 9, the federal Centers for Medicare and Medicaid Services (CMS) denied the Healthy Ohio Program 1115 Demonstration Waiver submitted by the Ohio Department of Medicaid. This waiver request was submitted to CMS in late June, as required in law by the Fiscal Year 2016-17 Operating Budget.
The Section 1115 waiver request to CMS asked federal regulators to allow Ohio to charge premiums to nondisabled, working-age adults on Medicaid who have incomes of less than 138% of the federal poverty level, or about $16,200 a year. If approved, the waiver would have affected one million Ohioans by requiring that they establish Health Savings Accounts and pay annually to maintain their Medicaid coverage.
The Ohio Academy of Family Physicians submitted comments at both the state and federal levels opposing Ohio’s waiver application. During the State of Ohio public comment period, Medicaid received 956 comments (including comments from the OAFP) about the Healthy Ohio waiver application. The top reasons for opposing the waiver application included:
- Healthy Ohio would be unaffordable for Medicaid recipients
- Healthy Ohio would result in decreased Medicaid enrollment
- Healthy Ohio would be too complex for Medicaid recipients, resulting in premiums not being paid and coverage being lost as a result
- Medicaid recipients would forego medical care in order to meet other expenses.