In a May 10 editorial, The Columbus Dispatch opposed the state’s Healthy Ohio 1115 Medicaid Waiver application calling it “misguided.”
According to the editorial, “This program, if approved by federal regulators, would require many beneficiaries to pay into a modified health savings account. The fees sound modest — 2% of family income, with a cap of $99 a year ($8.25 a month). But the working poor say they could face a choice of paying premiums or buying supper. Federal regulators should say no.”
“On behalf of the 4,800 family physician, family medicine resident, and medical student members of the Ohio Academy of Family Physicians, I write to express extreme concern with the Ohio Department of Medicaid’s Healthy Ohio Program 1115 Demonstration Waiver application.
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. In fact, the Healthy Ohio Waiver, as written, threatens coverage of over 1 million adult Ohioans who now have coverage—a huge step backward rather than continuation of earlier progress made possible by the Affordable Care Act (ACA) and Medicaid expansion.
Premiums have been a feature of Medicaid’s waiver programs in other states and have consistently resulted in program disenrollment and participation decline. That means people are not getting the health care they need. Research also shows that the cost of administering nominal co-pays or premium payment programs far exceeds the value of the premiums or co-pays collected. Furthermore, Medicaid expansion has improved care by transitioning services from expensive hospital emergency departments to less expensive outpatient settings.
Supporters of the waiver application would have you believe that Ohio’s waiver proposal is very similar to the Indiana waiver that the Centers for Medicare and Medicaid approved. The truth is Ohio’s proposal is far more drastic and harmful as Ohio’s plan locks out all participants (except pregnant women) from basic Medicaid coverage if they are unable to pay premiums. Indiana provides participants with basic Medicaid coverage if they fail to pay premiums as long as they are at or below 100% of the federal poverty level or if they were unable to pay the premium due to domestic violence, living in a county with a disaster declaration, being medically frail, and other exceptions deemed necessary. Ohio offers none of these exceptions.
The bottom line – the Indiana waiver decreased the number of uninsured individuals and increased the number of individuals with Medicaid coverage. Ohio’s waiver would do the exact opposite – increase the number of uninsured and decrease the number of individuals with Medicaid coverage. This is not the direction we want to head as a state or nation.
Please reject Ohio’s 1115 waiver application for what it is—another way to dismantle the ACA by eliminating Medicaid coverage for those who need it most. This waiver application is a foolhardy attempt to take Ohio back to a point that is even worse than its pre-Medicaid expansion days when large numbers of our most vulnerable populations lacked health care coverage.”
The public comment period for the application ended May 13.