Ohio Medicaid ExpansionPolicy and Politics

Greater Cleveland Congregations (GCC) is a non-partisan coalition of faith communities and partner organizations in Cuyahoga County working together to build power for social justice. GCC unites people

across lines of race, class, religion, and geography to promote public, private and civic sector actions

which strengthen and improve the quality of life of our neighborhoods.

Affordable Care Act

1. Expands Health Insurance CoverageA) Allows young adults to stay on parents’ planB) Provides subsidies to help people buy private insurance on

an “exchange”C) Expands State Medicaid Program to all adults earning

under 138% of the Federal Poverty Level

2. Makes Private Insurance BetterA) People can’t be rejected for pre-existing conditionsB) No caps on the amount of coverage (won’t “run out”)C) Requires full coverage of some preventative measures

3. Requires Everyone to Buy Insurance (“Individual Mandate”)

4. Starts to experiment with ideas to reduce costs.

Supreme Court Says:

1. Expands Health Insurance CoverageA) Allows young adults to stay on parents’ planB) Provides subsidies to help people buy private insurance on

an “exchange”C) Expands State Medicaid Program to all adults earning

under 138% of the Federal Poverty Level – now ‘optional’ for states

2. Makes Private Insurance BetterA) People can’t be rejected for pre-existing conditionsB) No caps on the amount of coverage (won’t “run out”)C) Requires full coverage of some preventative measures

3. Requires Everyone to Buy Insurance (“Individual Mandate”)

4. Starts to experiment with ideas to reduce costs.

Current Medicaid in Ohio

1. Covers approximately 2 million OhioansA) Children under 19 in families below 200% FPLB) Parents under 90% FPLC) Disabled Ohioans under 64% FPL (or 250% if working)D) Nursing home care for low-income seniors

2. Paid for by Combination of State and Federal GovernmentA) Federal Government Share: 72%B) Ohio Share: 28%

3. Expansion Now Allowable under Affordable Care Act in 2014A) All adults under 138% FPLB) Paid for: 100% by Federal Government in 2014-2016,

down to 90% by 2019

What is at Stake for Ohio1. Health insurance coverage for 800,000 of the state’s

poorest residents: Lives saved through health care

2. $17.13 billion in new Federal money into Ohio over 6 years, at a cost of only $870 million to the StateA)Up to $67.321 billion in business activityB)Tens of thousands of new jobsC)Reduced cost sharing for the insured

3. Income and Savings to State and Local GovernmentA)Health insurance sales taxB)Health care for prison populationC)County and State mental health spendingD)Local ambulance/EMT costs

1. Financial health of hospitals and providers.

Who Decides for Ohio?

1. The November 2012 election will set the context.A) A change in the Federal Executive and Legislative

branches may change the policy reality of the Affordable Care Act.

B) Voter turnout trends in Ohio will send signals to Columbus.

1. Governor John Kasich will make a recommendation in his budget proposal.A) Currently in the worksB) Will be announced in early February 2013

2. Ohio Senate and House of Representatives come up with their own budget proposals, in negotiation with each other and Governor Kasich

3. Final budget – including decision on Medicaid expansion – will be voted into law and signed by Gov. Kasich in June 2013.

Policy Issues

1. Governor Kasich has linked Medicaid Expansion to finding the funding for the “woodwork/welcome mat” effect.

2. Many states (including Ohio) are awaiting guidance from the Obama administration on whether a “partial expansion” will be allowed.• Up to 100% FPL rather than 138%• 100-138% Ohioans go into the Exchange rather than

Medicaid• Unknown cost sharing/benefit

package/complications

3. How much will it really cost? How much will it really save?

Opportunities for Action

1. Recruit for Northeast Ohio Medicaid Expansion Coalition

2. Identify testimonies of people affected by Medicaid expansion.

3. Enlist business support

1. Weigh in with State Representatives and Senators• Senator Bill Patton (District 24)• Rep. Nan Baker (District 16)• Rep. Marlene Anielski (District 17)• Rep. Mike Dovilla (District 18)

2. Weigh in with Governor Kasich