Medicaid expansion nixed from Ohio budget

5:56 PM, Apr 10, 2013   |    comments
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BEREA -- Hundreds of Northeast Ohioans will board buses bound for Columbus in the morning to protest Medicaid expansion being dropped from the state's budget proposal.

Hospitals, religious groups, social organizations and businesses support the measure but many Ohio republicans don't trust the Federal government will live up to its end of the funding bargain.

The measure includes $13 billion in federal dollars over the next seven years to cover healthcare for nearly 300,000 uninsured Ohioans. 

The proposal is supported by Republican Governor John Kasich. 

Reverand Gayle Catinella, of St. Thomas Episcopal church in Berea has been stumping for Medicaid expansion for months.  Even testifying before the legislature.  Not only will the measure benefit many of her parishoners, but also her developmentally disabled son who falls through the cracks. 

Currently the GOP is the overwhelming majority in the house and there's not enough votes to pass it.  

Read the Cleveland Clinic's position on the matter:

Opponents of Expanding Medicaid in Ohio Make Bad Arguments

By David L. Bronson, M.D.

President of Cleveland Clinic Regional Hospitals

President of the American College of Physicians

April 9, 2013

State legislators are deciding if they will support extending Medicaid coverage to about 275,000 fellow Ohioans. A few legislators in the Ohio House of Representatives appear to be more concerned with politics, rather than people who are without reliable health care.

Some Ohio House members are hanging their hats on arguments not based in fact. Here are their key objections and the facts that refute them.


We cannot trust the federal government to keep its promise of generous support for expansion.


Ohio is under no obligation to continue this expanded program if the federal government does not live up to its part of the bargain. The Ohio legislature has acted on several occasions in the past to reduce or eliminate programs, such as the General Assistance Program and the Disability Medical Assistance Program, to name just two. It can do so again.


Medicaid is broken, with some doctors not accepting Medicaid patients and health outcomes worse for those on Medicaid.


These arguments are intellectually dishonest. Ohio's system of Medicaid is the envy of other states. Today, Ohioans on Medicaid are getting better, more coordinated care, at much lower cost to taxpayers. In the current budget period alone, a savings of $2 billion has already occurred.

Part of the reason is that Ohio offers Medicaid through five managed care plans, no longer using a "fee-for-service" model. This is an important distinction that has been ignored in analyses used by those opposed to Medicaid expansion. Ohio's managed care health plans are experts in case management, patient-centered care and leveraging the marketplace to achieve reasonable costs from providers. Ohio's Medicaid managed care plans also are required to carry the risk involved, if treatment isn't successful. The plans have a strong incentive to make sure patients get the right treatment the first time, because they will be liable for the costs if patients aren't better and require more treatment.

The studies on medical outcomes cited by opponents do not offer a fair comparison of groups of patients. In contrast, the Ohio Medicaid Assessment Survey has consistently shown that uninsured people have higher levels of unmet need and more access problems than those on Medicaid. It has also shown that people on Medicaid have no worse access to health care than similarly situated people with private insurance.

In addition, the outcomes argument fails to recognize that many uninsured people seek treatment too late. With no way to pay for medical treatment, many people wait until their condition is advanced, reducing their chance for recovery. Getting these people to more dependable care in a Medicaid plan will improve opportunities for preventive care and chronic disease management.

Finally, some doctors not accepting Medicaid patients is nothing new, but Ohio's strong system of free clinics and community health centers pick up the slack. In addition much work is being done to determine how other medical professionals, who are not physicians, may be able to do more treatments for patients.


Premiums for private insurance will rise because Medicaid does not fully compensate for treatment. Hospitals will pass along uncompensated costs to insured customers.


First, it will be cheaper for hospitals to treat Medicaid patients at the government's rate of compensation than to treat uninsured patients with no ability to pay. Second, hospitals are overwhelmingly supportive of Medicaid expansion, which would be against their best interest if Medicaid really were a bad deal for them.


The federal dollars for Medicaid expansion are Ohio taxpayer dollars as well, and Ohioans should not contribute to out-of-control federal spending.


Refusing to expand Medicaid in Ohio will not solve the problem of federal spending, but it will allow Ohio's federal tax dollars to be used elsewhere. Ohio tax dollars should work for Ohioans, to improve health for low-income citizens, support health care providers, provide treatment for people who may pose a public safety risk, and build a more efficient and effective system for keeping Ohioans healthy and productive.

By choosing to expand Medicaid in Ohio, the state will receive more than $23.8 billion in federal funds over the next six years, money that will boost state and local public health programs and relieve the expensive care burden from hospitals. In addition, it is estimated that as much as $2.3 billion will be saved by getting people into doctor's offices rather than emergency rooms over this same period.

Please join the Cleveland Clinic to urge our state lawmakers to put politics aside, and stand up for Ohioans and better health.


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