Before state officials decide whether to expand Medicaid eligibility under the Affordable Care Act, they say they first must continue to examine the cost (Source: "Ohio weighs future expansion of Medicaid," Toledo Blade, Oct. 16, 2012).
With passage of the ACA, Ohio Medicaid is already expecting an increase in enrollment as part of the so-called "woodwork effect," where those who are currently eligible begin to enroll in larger numbers in order to comply with the law's requirement that individuals have health coverage.
"How do we, in the current budget situation, pay for these individuals that are currently eligible but not enrolled?" said John McCarthy, Ohio's Medicaid director, speaking in a meeting Monday with members of The Blade's editorial board. "That is the part we are focused on now and working through. Then, at the same time, we're looking at all the items around the expansion."
Under the ACA, states have the option to expand Medicaid eligibility in 2014 to everyone making up to 138 percent of the federal poverty level (currently $31,809 for a family of four). While the cost of covering the newly eligible will be paid entirely by the federal government for the first few years after implementation, that reimbursement rate eventually drops to about 90 percent of the cost by 2020. The expansion is estimates to add as many as 1.1 million new enrollees to the program, which already covers 2.2 million Ohioans.
"We're trying to answer all these questions to present the Governor with our recommendations and with options," said McCarthy.
At an HPIO forum earlier this month on access to care, McCarthy said that the administration likely would make a decision on Medicaid expansion early next year as part of the biennium budget process.