LIMA — In a town with so many health care jobs, Gov. John Kasich backing an expansion of Medicaid is welcome news.
As he unveiled his 2014-2015 state budget proposal, Kasich said he will push for expanding Medicaid in Ohio under the federal health care law, increasing access to care for tens of thousands of working poor in the state.
“We view it as a positive thing and strongly support the governor’s decision to include the expansion of Medicaid in his budget,” said Bob Baxter, president and CEO of St. Rita’s Health Partners.
Baxter sees three big positives: a win for working Ohioans not able to afford insurance now; a win for Ohioans, who will see more of their tax dollars come back to Ohio; and a win for hospitals that care for people regardless of their ability to pay.
“Our uncompensated care in the last five years has gone up by 70 percent,” Baxter said. “This will make a significant impact.”
Currently, 2.3 million people in Ohio receive health care from Medicaid. Expanding the program to 138 percent of the federal poverty level ($15,400 for an individual) would make another 365,000 people eligible. While the federal government currently pays states 60 cents of each Medicaid dollar spent, it will increase that to 90 cents for states choosing to broaden the program.
Getting more people access to care will in the long run take costs out of the system, Baxter said. It will mean more people seeing a regular doctor instead of using a hospital emergency room for primary care and fewer hospital re-admissions, Baxter said.
The system has some holes, said Dr. Susan Hubbell, of Physical Medicine Associates of Northwest Ohio. Hubbell is also the region’s representative to the Ohio State Medical Association Council.
The association does support the Medicaid expansion, Hubbell said, with some concerns.
“It’s not gung ho. There are a lot of issues,” Hubbell said. “Access to insurance doesn’t automatically mean access to care.”
While Medicaid is increasing the reimbursement rate to primary care physicians, it won’t be increased for specialists, Hubbell said, so many doctors, especially those that remain in private practice, are limiting Medicaid patients because the reimbursement isn’t enough to pay the bills.
Many doctors have left that model behind in favor of becoming a salaried employee of a group, Hubbell said, but many remain in private practice.
“We’re paying the bills just like any other business,” Hubbell said. “It has to be enough to break even or stay in business, and what’s left over is the doctor’s salary.”
Hubbell also has personal concerns about whether the federal system can be sustained financially, she said.
Baxter said the issue is a complicated one that will require discussion about specific issues, but he is pleased first to see the idea of expansion be supported by the governor. Baxter also pointed to multiple studies showing a net positive gain for the overall economy with the expansion.
Kasich’s plan calls for an “opt-out” provision if the federal government isn’t covering its share of coverage. Kasich has been splitting political hairs this week, making the argument he still opposes the individual mandate of “Obamacare” while accepting the Medicaid expansion.
The plan must be approved by the Republican and staunchly conservative Legislature.
On Monday, Kasich also proposed a new funding formula for higher education. The formula ties half of state subsidies for state universities and colleges to the number of students who graduate rather than how many attend.
OSU-Lima Dean John Snyder said the smaller campuses of Ohio State are analyzing the impact of the new formula.
Kasich’s plan also removes the separate funding formula for regional campuses. Funding will no longer be set aside in the formula and distributed separately for regional campuses. Instead, all students in the university sector will be treated the same, regardless of location.
The performance-based funding plan would apply to community colleges as well. The enrollment-based funding formula would be eliminated in fiscal year 2015, with all community college funding allocated among degree completion, course completions and success points. The specific percentages allocated will be determined by community college leaders and the chancellor.
Rhodes State College President Dr. Deborah McCurdy said the school anticipated the change in broad strokes, and she and her leadership team were reading the fine print. She believes the school will fare well under a performance-based system and already is serving as a model on some of the criteria. Rhodes State has increased its post-secondary course options for high school students and has strong course completion numbers for workforce development.
A focus on completion will benefit Rhodes, McCurdy said.
“We continue to grow and demonstrate completion, and that’s what’s going to have the positive impact on our funding overall,” McCurdy said. “We’ve made positive inroads with the governor’s staff over the years with the workforce development contributions two-year colleges can make.”
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