On March 1, the Ohio Academy of Family Physicians submitted comments opposing Ohio Medicaid’s waiver request to the Centers for Medicare and Medicaid Services (CMS) to implement work requirements for Medicaid expansion enrollees.
“As primary care physicians serving on the front lines of patient care in Ohio, we know firsthand that approval of Ohio’s waiver application would be a devastating blow to progress made in providing health care coverage to Ohio’s Medicaid and other low-income populations, said OAFP President Don Mack, MD. “This waiver application, as written, threatens coverage of an estimated 36,000 adult Ohioans who now have coverage – a huge step backward in achieving the American Academy of Family Physicians’ long-standing goal of achieving health care coverage for all.”
“This waiver, if approved, reverses gains made when Medicaid was expanded and care was improved by transitioning services from expensive hospital emergency departments to less expensive outpatient settings,” Dr. Mack went on to say. “Reducing coverage and access is not the direction we should be heading as a state or nation.”
Many of the 700,000 Ohioans enrolled in the Medicaid expansion already work – 58% earned income in the previous year and 44% currently meet the work requirement. Additional enrollees are exempt from the requirement based on Ohio law and new federal guidelines. As a result, an estimated 95% of the current Medicaid expansion population will meet the work requirement or be exempt, but the remaining 5% – about 36,000 individuals – would need to seek work or otherwise comply with the requirement to remain enrolled in Medicaid.
To comply with the work requirement, Medicaid expansion enrollees will need to demonstrate they work at least 20 hours a week or are engaged in other allowable activities, including job search, education and training, or unpaid work in certain cases. New enrollees must meet the requirement when they enroll, and current enrollees must meet the requirement during their annual eligibility renewal. Failure to meet the requirement results in termination of Medicaid benefits. Limited exceptions may be granted, for example for a family emergency or illness.
The AAFP has warned that states, like Ohio, who seek the flexibility to change their Medicaid programs should be careful to not harm patients by reducing access or erecting unnecessary barriers to care.
Public comment on the waiver is open through Sunday, March 18. Based on input received, Ohio Medicaid will finalize the application and submit it to CMS for review. CMS will post Ohio’s waiver application online for at least 30 days and then wait at least 45 days after submission before making a decision.
Group VIII Work Requirements and Community Engagement 1115 Wavier
Bureau of Health Plan Policy, Ohio Department of Medicaid
50 W. Town St., 5th Floor
Columbus, OH 43215