On December 30, 2016, the Kasich administration released a report on Medicaid expansion in Ohio. The report found that Medicaid expansion provided coverage to 702,000 low-income Ohioans, the vast majority of whom were previously uninsured. Those enrollees reported “increased access to usual and appropriate sources of care, better management of chronic diseases and health risk factors, and reductions in emergency department use.”
In an interview with The Columbus Dispatch, Ohio Director of Medicaid Barbara Sears stated, “This report clearly illustrates the benefits of extending Medicaid coverage to more low-income Ohioans, including helping to identify and control expensive chronic health conditions, while also making it easier for them to find and keep a job.”
House Bill 64 of the 131st General Assembly required the Ohio Department of Medicaid to provide the report evaluating the impact of Ohio’s 2014 Medicaid expansion. Guided by the General Assembly’s request, Medicaid’s analysis examined how Medicaid expansion has affected new enrollees with respect to access and utilization of health care, physical and mental health status, financial distress/hardship, and employment.
The report’s summary states:
“According to the analysis conducted, many enrollees were diagnosed with a previously unknown chronic health condition for which they are now able to seek care. Because they were able to obtain treatment for previously untreated conditions, several of the enrollees stated that they did not think they would be alive today if Medicaid expansion had not occurred. The review of medical records confirmed that enrollees experienced improved chronic disease and health risk factor management for conditions such as heart disease and depression resulting from appropriate access to statin prescriptions, antidepressant medications, and clinical health interventions. The medical records review also revealed an increase in the likelihood of an enrollee visiting his or her medical provider at least twice annually.
In addition to the reduction in unmet medical needs, enrollees also reported substantial declines in overall stress and financial hardship. Most enrollees reported that Medicaid made it easier to seek employment or remain employed. During focus group discussions, some participants mentioned that Medicaid allowed them to get treated for chronic conditions that prohibited them from working when they were uninsured.”
- Access to physical and mental health care
- Health care utilization and reduced emergency department use
- Detection of unknown or unaddressed prior health conditions (particularly chronic health conditions)
- Security of and opportunities for employment
- The lessening of family financial stress
- Declines in medical debt-holding
- An increase in the ability to pay other nonmedical bills (e.g., household utilities, food, transportation).
These results are similar to studies in other states that have found Medicaid expansion to be associated with improved access to and utilization of needed medical care (California, Maine, and Massachusetts), increases in general health statuses (Arizona, Maine, Massachusetts, and Minnesota), and reduction in stress?including financial stress (Minnesota and Oregon), and more appropriate health care utilization (a review of all expansion states).
Finally, despite the short time elapsed since Medicaid expansion, enrollees reported modest physical and mental health status gains, and most reported an increase in household, employment, and health security. Overwhelmingly, new enrollees reported being grateful for their Medicaid expansion health care coverage and valued having access to Ohio’s health care system.
Ohio is one of 31 states that expanded Medicaid under the Affordable Care Act.