During consideration of the state budget enacted June 30, 2015, the Ohio General Assembly included a provision that required the Ohio Department of Medicaid (ODM) to seek federal permission to mandate enrollment in a Health Savings Account (HSA) for every non-disabled adult enrolled in Medicaid.
In keeping with the dictates of the statute, state officials, on July 1, submitted a Section 1115 waiver request to Centers for Medicaid and Medicare Services (CMS) asking 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 affect one million Ohioans by requiring that they establish an HSA and pay annually to maintain their Medicaid coverage.
- 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.
CMS will open its own public comment period and then decide what, if any, parts of the waiver request to which it will agree. The OAFP plans to again submit comments opposing the waiver. At that point, negotiations can occur between CMS and Medicaid (assuming that additional state legislation passes to permit those negotiations to occur). There is no formal deadline for CMS to respond to the state for 1115 waiver decisions.
For more information, view a summary on the Healthy Ohio Program.