Source: Center for Community Solutions
The House Republican’s American Health Care Act (AHCA) establishes an alternative Medicaid financing plan built on per capita caps. Research conducted by The Center for Community Solutions in Cleveland finds that the Ohio all funds reduction, as the result of the proposed Medicaid per capita cap, would be between $19 and $25.6 billion between Fiscal Years 2019 and 2025.
- Even if Medicaid expansion is maintained with an 80% federal matching rate, Ohio would need to contribute or cut $6.4 – $8.5 billion in state funding through 2025 to maintain projected funding levels for the entire program, with specific population funding changes as follows:
- Children: Shortfall of $2 – 2.3 billion
- Adults: Shortfall of $3 – 4.3 billion
- Disabled: Shortfall of $2.2 – 2.7 billion
- Aged: Surplus of $1.9 billion
- Group VIII: Shortfall of $900 million – 1.1 billion
- It is unclear if a per capita model would conflict with standards of actuarial soundness, potentially compromising the ability for Ohio to have a privatized delivery system through managed care
Upon release, author Loren Anthes, public policy fellow in the Center for Medicaid Policy said, “Under Governor Kasich’s leadership, Ohio’s privatized Medicaid program has been fiscally efficient while covering more lives. The legislation as written, however, creates significant structural issues for Medicaid funding, ultimately shifting costs and risk to states.”
Gov. Kasich has been very visible in advocating for both parties in Congress to work together to fix the Affordable Care Act. He recently was a guest on NBC’s Meet the Press and he also published a guest column in The New York Times encouraging Republicans and Democrats to work together on a solution.
In regards to the impact on the 1 in 4 Ohioans covered by Medicaid, Mr. Anthes continued by stating “Lower costs is a necessity of good policy in Medicaid, but the per capita proposal is about lower reimbursement, not lower costs, and will most likely lead to significant gaps in care for Ohio’s children, the disabled, pregnant women, victims of human trafficking, and those struggling with opiate addiction.”