Ohio officials still seek Medicaid flexibility
COLUMBUS, Ohio — Ohio continues to press the federal government for flexibility as state lawmakers review whether to expand the Medicaid program under President Barack Obama’s health care law.
Greg Moody, director of the governor’s Office of Health Transformation, told reporters Tuesday he’s encouraged by discussions with the Obama administration, but he said it’s too soon to say the two sides have reached an agreement.
Republican Gov. John Kasich has discussed whether Ohioans newly eligible for Medicaid under an expanded program could instead get private coverage subsidized by Washington. Those low-income individuals could then purchase insurance in the new health insurance market, known as the exchange.
“I believe we are getting closer, but we are not going to raise hopes until we’re pretty certain that even at the technical detail, we can get this done,” Moody said.
The state anticipates roughly 366,000 low-income Ohioans will be eligible for coverage beginning in 2014 by expanding Medicaid, the health program for the poor that already provides care for one of every five residents in the state.
Kasich announced last month in his two-year state budget proposal that he would push for expanding Medicaid, but he wants to know whether the state has flexibility to implement the expansion.
The Ohio Legislature, controlled by Republicans, will have to approve Kasich’s decision. And many of them are averse to the Democratic president’s signature health care law and resistant to expanding government programs.
In an expanded Medicaid program, the federal government would pay the entire cost for the first three years, gradually phasing down to 90 percent — still well above Ohio’s current level of 64 percent. But even at those generous rates, some Republicans in the Legislature say they fear being stuck with long-term costs.
Ohio Medicaid Director John McCarthy has discussed flexibility around expansion with federal officials and other states’ counterparts as recently as Monday, Moody said.
Among the open-ended questions are what benefits could those low-income individuals receive in the new health insurance exchange and whether the state could impose a co-payment. Moody declined to be more specific about what the state might want.
“We’re not going to talk about details because we’re still having those conversations,” he said.
The federal law expanded Medicaid to cover low-income people making up to 138 percent of the federal poverty level, or about $15,400 a year for an individual. The provision will mainly benefit low-income adults who do not have children and currently can’t get Medicaid in most states.
Separately, the overhaul provides subsidized private insurance for middle-class households.
The U.S. Supreme Court later gave states the choice of participating in an expanded Medicaid program.
Kasich is one of eight Republican governors to endorse the expansion despite misgivings about the health care overhaul.
Moody said he has been meeting with Republican and Democratic lawmakers on the Medicaid expansion proposal, which is being reviewed in Ohio House hearings.
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