Medicaid cuts would impact more than a quarter of Ohioans, children and the elderly most of all
Budget cuts at the federal and state level have the potential to raise the uninsured rate in Ohio and put health coverage in jeopardy for a large part of the state.
A study of state and federal data by the Ohio-based Center for Community Solutions found that more than a quarter of the state’s population receives health coverage through Medicaid.
Medicaid in Ohio covers two in five children, one in five working-age adults and one in 10 adults aged 65 and older, according to the center.
The largest group in the state’s Medicaid caseload is families and children, making up 53.2% of the cases, followed by the 25.5 percent covered by the Medicaid expansion. Older Ohioans, along with the blind and disabled, make up 16.6 percent of the caseload.
Since Medicaid was expanded in Ohio, the uninsured rate in the state dropped by half, state data say. The Health Policy Institute of Ohio has stated that the Medicaid expansion “has been a major contributor to Ohio’s uninsured rate dropping by half from 14 percent in 2010 to seven percent in 2022.”
“Preventive care and treating conditions early reduce the need for high-cost emergency room visits, long hospital stays and additional public spending,” the Center for Community Solutions study on Medicaid stated.
Nearly 50 percent of the 769,520 Ohioans who are on Medicaid expansion are a part of the state’s workforce, and others on the expansion are “students, caretakers, or dealing with a chronic health condition,” the center found.
This is notable as the Trump administration and Congress look at cuts to Medicaid as part of proposals to slash federal spending overall, along with proposals regarding work requirements for the program.
Ohio is looking into its own cost-cutting measures, including a provision built into the House’s version of the budget that would trigger cuts to Medicaid in Ohio should the federal government reduce the contribution it makes to the state’s Medicaid coffers.
The Ohio House and Gov. Mike DeWine’s budget proposals would eliminate Group VIII, the group included in the Medicaid expansion, if the federal government stops funding 90 percent of the expansion.
Advocates and supporters of Medicaid fear that $880 billion could be cut from Medicaid in the budget reconciliation process underway in D.C. They say that would have devastating consequences for low-income areas and those in most need of help.
According to health policy researchers at KFF, $880 billion in federal cuts over the next decade would represent 29 percent of per-resident spending on the program, They say the federal cuts “are equivalent to all Medicaid spending on 3 million seniors and people with disabilities, 14 million other adults or 22 million children enrolled in Medicaid.”
Nationally, Medicaid has an enrollment of 72 million, many of whom are in Republican-led states like West Virginia, Arkansas, and U.S. House Speaker Mike Johnson’s home state of Louisiana. Johnson has claimed the program has billions in yearly waste, fraud and abuse.
Edwin Park, a research professor at Georgetown University’s McCourt School of Public Policy, discussed the cuts during a panel discussion hosted by the USC Center for Health Journalism. Medicaid covers 40% of all births in the country, with more than one-third of Medicaid enrollment represented by children, Park said.
Unlike the federal government, states are required to balance their budgets, therefore Medicaid cuts at the federal level would necessitate cuts by the states.
“These cuts are very large, and states would not be able to sustain their current Medicaid programs as is over the long run,” Park said.
To compensate for a loss in federal funding, Park said states could cut Medicaid programs. They could also cut other parts of their budgets, which would most likely be education funding because it’s another of the most expensive programs. Or states could raise taxes dramatically.
From Park’s perspective, states would probably start with cuts to optional Medicaid services, such as vision and dental coverage, and try to obtain waivers for certain parts of Medicaid, such as prescription coverage.
A loss of just the Medicaid expansion group in Ohio would cost 770,000 Ohioans their coverage. It’s a group that is made up of 19 to 64-year-olds who have household incomes less than 138 percent of the federal poverty line, and who aren’t eligible for other Medicaid coverage. For a family of four, that’s about $44,000.
There are high Medicaid enrollment rates in Southeast Ohio and rural counties, including House Speaker Matt Huffman’s home in Allen County, where Medicaid covers 28 percent of the population.
The Senate is hashing out its budget ahead of the July 1 deadline. Fifteen percent of Henry County, where Senate President Rob McColley lives, is covered by Medicaid as of March of this year.
Pike County had the highest Medicaid rate in the state last month, with 42 percent of residents covered by traditional Medicaid, and 10 percent in the Medicaid expansion group. Neighboring Scioto County had a 41-percent Medicaid enrollment, and 12 percent of its population in the expansion. Clark, Adams, Lawrence and Gallia counties all had similarly high rates, above 30 percent for traditional Medicaid, and between eight percent and 11 percent in the expansion group, according to state data and Center for Community Solutions analysis.
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