The Affordable Care Act (ACA), known broadly as Obamacare, was signed into law in 2010 with the primary goal of reducing the number of uninsured Americans by expanding health insurance options. For adults in or near poverty who did not qualify for Medicaid’s parent coverage, this goal was to be accomplished by extending Medicaid to all adults under age 64 with incomes less than 138 percent of the federal poverty level. Some of these individuals are working but cannot afford or are not offered employer sponsored insurance. The Medicaid extension was fully federally funded through calendar year 2016 and is 95% funded in 2017. The Supreme Court ruled in 2012 that the ACA is constitutional, but made Medicaid extension optional for states.This means that each state can decide whether or not to extend. The major components of the ACA, including Medicaid extension, went into effect at the beginning of 2014. Medicaid Extension provides health insurance for over 650,000 Ohioans.
Ohio Medicaid Facts (Kaiser Family Foundation):
• Nearly 3 million people in Ohio are covered by Medicaid (21% of the total population). While four in five (79%) of enrollees are children and adults, more than one-half (59%) of the state’s Medicaid spending is for the elderly and people with disabilities.
• 345,300 (17%) of Ohio’s Medicare enrollees are also covered by Medicaid, which accounts for over two-fifths (41%) of Medicaid spending.
• 40% of all children in Ohio are covered by Medicaid, including 46% of children with special health care needs.
• 59% of nursing home residents in Ohio are covered by Medicaid and 39% of Medicaid long-term care spending in Ohio is for nursing home care. Medicare beneficiaries rely on Medicaid for assistance with services not covered by Medicare, particularly long-term care.
• 88% of Medicaid enrollees in Ohio are in managed care. Since Ohio has already transitioned most enrollees to managed care, it would not be able to recoup much of the one-time savings that some states experience during that transition.
• Ohio has a below average per capita income and therefore a relatively high federal Medicaid matching assistance percentage (FMAP) at 62.3%. For every $1 spent by the state, the federal government matches $1.65. Almost three quarters (72%) of all federal funds Ohio receives are for Medicaid. In Calendar Year 2017, the federal match rate for the Medicaid expansion population is 95%.
United Way of Greater Lorain County Position
United Way of Greater Lorain County (UWGLC) supports the continuation of the Medicaid Extension, making healthcare accessible and affordable to adults working in low-wage jobs and their families. UWGLC does not support the expansion freeze proposed by the Ohio General Assembly but vetoed by Governor Kasich.