Democrats question whether budget creates health barriers

First Posted: 2/11/2015

COLUMBUS (AP) — Democrats on a state legislative panel questioned Wednesday whether Republican Gov. John Kasich’s budget would create barriers to health care after the administration recently increased access for thousands of low-income residents.

The Kasich administration wants to charge a monthly premium to certain recipients on Medicaid, the federal-state health care program for the poor and disabled.

The proposal comes after the governor extended Medicaid eligibility in 2013 to cover more people. Roughly 451,000 Ohioans have enrolled under the extension, which boosted eligibility to those with incomes up to 138 percent of the federal poverty level, or about $16,243 for an individual.

The governor’s $72.3 billion state spending plan would continue to fund the Medicaid expansion.

But the Kasich administration has proposed charging a monthly fee to an estimated 100,000 Medicaid recipients with incomes above the poverty line of about $11,770 for individuals. Those residents could pay an average of $20 per month to access Medicaid coverage, administration officials said. The plan requires federal approval.

The governor has pitched the idea as helping to drive “personal responsibility” in the program and make it easier for residents to transition off the Medicaid to private coverage when they can.

Administration officials, including the directors of Ohio Medicaid and the state’s Job and Family Services Department, testified on the idea Wednesday before the House Finance Committee.

Democrats on the panel told the administration that they saw the premiums in conflict with expanded Medicaid coverage, fearing it could lead people to drop off the program because they couldn’t pay the cost.

State Rep. Dan Ramos, a Lorain Democrat, said the premiums could turn into “more of an unnecessary burden or obligation.”

“We’re talking about people who have responsibilities,” Ramos said, noting that the recipients likely had a job and were paying rent and bills.

Ohio Medicaid director John McCarthy said the administration did not believe anyone would drop out of the system.

“We are assuming that nobody will lose their coverage because of the change,” McCarthy said. He said if the state had not expanded Medicaid, residents at that income level would be paying premiums and other costs for coverage in the federal health insurance marketplace.

Greg Moody, director of the governor’s Office of Health Transformation, said he also was sensitive to the challenges that residents could have in paying premiums. But, he said, those on the program whose incomes increase would have to pay premiums for health coverage once they leave the Medicaid program. “If they don’t have experience with that, the likelihood of losing that and dropping that and being uncovered and at risk of a disease that puts them back out of work, we think goes up,” he said.

Moody said he believed the proposal was fair in mirroring current federal law.

The provision is expected to save the state $1.6 million in 2016 and $3.2 million in 2017.

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