Ohio Medicaid: Overview
Medicaid is a joint federal/state program, established in 1965, that provides health insurance to eligible low-income and medically vulnerable populations. Ohio Medicaid and other government health insurance programs provide a safety net for specific populations that might otherwise have difficulty obtaining coverage.
To be eligible for federal funds, Ohio Medicaid and other state programs are required to provide coverage to certain groups of individuals and can choose to extend coverage to other categorically needy groups. While there are over 25 different eligibility categories for which federal funds are available, these groups are often classified into four broad groups:
- Covered families and children (comprising eligible parents, children and pregnant women)
- The aged, blind and disabled (ABD) population
- Medicaid Expansion (often referred to as Group VIII)
- Other Medicaid
Ohio Medicaid Funding
As Medicaid continues to absorb ever larger portions of both state and federal budgets, there is growing concern about the future affordability of the program. For federal fiscal year 2018, the federal government's percentage on Medicaid expenses in Ohio is 62.78 percent.
Ultimately, the challenge is that controlling costs is not straightforward when it comes to Ohio Medicaid and other state Medicaid programs. While policymakers can decide to limit spending, the health needs of the population do not go away. Spending may be cut in one area only to resurface as an increased expense in another area. Cut eligibility, for example, and people who have lost access to primary care turn to hospital emergency rooms, oftentimes with more expensive health problems after having put off seeking care.
Passage of federal healthcare reform has had a significant impact on the Medicaid program. Starting in 2014, states had the option of expanding Medicaid coverage to nearly all individuals under the age of 65 with incomes up to 138 percent of the federal poverty line (133 percent of the federal poverty line plus a 5 percent income disregard). Ohio chose to expand its Medicaid program to cover this newly eligible population and has since witnessed a decrease in the state’s uninsured rate.
The Medicaid program provides health insurance to some of society’s most vulnerable members and remains an important part of the healthcare safety net. As Medicaid continues to absorb big shares of state and federal budgets, conversations about how to finance the program – including the potential for cuts in coverage or reimbursement – persist in policy circles. Given Ohio Medicaid’s impact on the health of the population and hospitals’ bottom lines, The Center for Health Affairs works diligently to stay abreast of the latest developments in Ohio Medicaid reimbursement and coverage policy. As the leading advocate for Northeast Ohio hospitals, The Center helps to coordinate efforts to protect Medicaid coverage and ensure appropriate reimbursement.