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Ohio Medicaid Work Requirements: A Step Backwards on Health-Care Access?

Researchers say most of the Medicaid program expense comes from enrollees who are elderly or have a disability. (rawpixel/Flickr)
Researchers say most of the Medicaid program expense comes from enrollees who are elderly or have a disability. (rawpixel/Flickr)
February 12, 2018

COLUMBUS, Ohio – State leaders in Ohio are making a push for Medicaid work requirements, but some researchers are cautioning that could turn back the clock on progress made to improve health-care access.

About 3 million Ohioans are insured through Medicaid, including more than 700,000 who were added during the 2016 expansion. According to a report by Loren Anthes, public policy fellow in the Medicaid Policy Center at the Center for Community Solutions, more than six in ten Medicaid enrollees in Ohio already work full- or part-time.

"The Legislature has a concept that a lot of the folks who are part of the Medicaid expansion are just siphoning benefits, but that couldn't be further from the truth," Anthes insisted. "In fact, most folks are on it for less than a year, and most of the expense of the program lies with the disabled and the elderly, not with the Medicaid-expansion enrollees."

The Centers for Medicare and Medicaid Services issued guidance in January asserting that work requirements can improve health and well-being, and help families gain economic stability.

Anthes counters that evidence from other safety-net programs shows that isn't the case, and said many Medicaid enrollees could lose coverage because they may not be able to meet the requirements, due to job or family commitments.

Medicaid work-requirement waivers were recently approved for Indiana and Kentucky, and have been requested by several other states. But Anthes noted there are questions about the legality of the waivers.

"In states where you've seen this move forward, there have already been lawsuits put out there," he said. "And I imagine that will be much the same here in Ohio, with a lot of this potentially tied up in courts and many folks concerned that this is a violation of the Social Security Act."

He cited economic concerns as well. Health care is the second-largest industry in Ohio, behind agriculture. He explained if too many people lose coverage, some medical facilities, particularly in rural areas, may need to close their doors.

"To suddenly remove these resources not only dis-benefits this huge area of employment and this huge area of economic impact for providers and others, it would have drastic impacts on things like the opioid epidemic, on chronic-disease management," Anthes said.

The American Medical Association and the American Academy of Pediatrics are among physicians' groups opposing work requirements, claiming they create barriers to getting health care.

Mary Kuhlman, Public News Service - OH