American Health Care Act brings new worries for Ohio Medicaid

This February, Ohio Gov. John Kasich met with President Donald Trump is discuss the importance of the Ohio Medicaid expansion that has led to over 700,000 Ohioans receiving access to health care since 2014. However, the recent introduction of the federal American Health Care Act could undo many of the benefits this expansion has brought to the buckeye state. The American Health Care Act (AHCA), introduced this past week, says it will allow people to stay on Medicaid and will also cover pre-existing conditions. But the creators of the bill also vow to eliminate federal funding to Medicare initiatives. According to state official estimates, federal funding cuts would most likely reduce Ohio Medicaid spending from $37 billion to just over $3 billion between 2018 and 2026. Prior to the expansion, Medicaid in Ohio was only given to adults with an income below 90 percent of the poverty line who were also a parent, pregnant or disabled. Since 2014, Ohio Medicaid is available to any Ohioan between the ages of 19 and 64 who is at or below 138 percent of the poverty line.A study conducted by the Ohio Department of Medicaid found the majority of those insured by Medicaid did not have jobs or four-year college degrees, and over 70 percent were not married. The expansion also provided easier care for those suffering from mental illness, who largely said the new care helped them find or keep work more easily, and helped about 27 of new recipients become aware they were suffering from a chronic condition.Although the AHCA still has staunch support from its creators — and Trump has made recent efforts to get the legislation more votes from within the GOP — its initial reception has been largely negative from both major parties, and it may not even pass as is. However, some still question how the act will impact the new changes to Ohio Medicaid if it does get passed with its current promises.In an opinion piece Kasich wrote for The New York Times this past week, he said federal legislation should consider both the cost and coverage of health care. He voiced concerns about the impacts that phasing out expanded Medicaid coverage could have in the 30 states that implemented it.Kasich wrote:

“It is unrealistic to think that cutting coverage saves any money, since we will only see uninsured people returning to the emergency room for their care — and walking away from unpaid bills. We can avoid that problem by embracing a plan that both preserves coverage for those who have it and achieves savings with badly needed Medicaid reforms. Not having a viable alternative is counterproductive and unnecessarily puts at risk our ability to treat the drug-addicted, mentally ill and working poor who now have access to a dependable source of care.”

In a statement on Meet the Press this past Sunday, Vice President Mike Pence touched on Kasich’s concerns.“I'm very confident that this legislation will give Ohio both the resources and the flexibility that your governor and your legislature will need to be able to meet those needs going forward and offer our most vulnerable citizens even better coverage,” Pence said.Kasich, however, however, disagreed with Pence’s statements.“He's not right. I mean, first of all, Medicaid expansion has covered 700,000 people in my state, a big chunk of whom are mentally ill and drug addicted and have chronic diseases. They tend to churn and move off of that program. Then they have to go to an exchange that's broken,” he said. “The current system doesn't work. That can be fixed. I've said it all along. It's not like we love Obamacare. It means don't throw the baby out with the bathwater.”Kasich also said the real secret to having sustainable health care for all, particularly those in Ohio, may rest in an already complicated issue: getting both major parties to work together.“Republicans and Democrats can start by working together to stabilize insurance markets, which are slipping into crisis in both red and blue states,” Kasich wrote in the Times. “If we are to establish a lasting and successful replacement for Obamacare, Republicans should reach across the aisle for help, and Democrats should accept the offer. Cutting Democrats out of the process will only make the results less effective. And if Democrats refuse to cooperate with Republicans, they will be forgoing the opportunity to solve a core problem for millions of Americans, including the most vulnerable, who are dependent on reliable health care coverage.”