FGA Offers Recommendations for Ohio Medicaid Reform

Published July 11, 2013

A Foundation for Government Accountability white paper published jointly with Opportunity Ohio detailed eight reasons Ohio should not expand Medicaid, despite the strong support for expansion by Republican Gov. John Kasich.

The paper was written by Jonathan Ingram, the research director for Florida-based FGA.

“The wisest course for Ohio policymakers is to reject Medicaid expansion, or, at the very least, delay any decision until there is a clear understanding of how it will impact patients and taxpayers,” Ingram wrote.

Ingram detailed multiple reasons Ohio should not expand Medicaid, including that Medicaid costs are already growing and jeopardizing all other state priorities, Ohio policymakers have no reliable cost estimates on which to base their decision, and Medicaid is already failing to meet its mission of protecting the state’s most vulnerable patients.

Uncompensated Care Problem Remains

Ingram’s report points out the costs of uncompensated care for Ohio hospitals are unlikely to diminish under the expansion.

“Proponents of the ACA’s Medicaid expansion argue that expanding Medicaid will reduce uncompensated charity care and cost-shifts to private insurance,” Ingram wrote. “But the experiences of states that have already expanded Medicaid tell a much different story, and are instructive for Ohio lawmakers. In those states, these same promises of reduced uncompensated charity care and cost-shifting were made by expansion supporters.

“Those expansion supporters were unable to keep their promises in those states and will likely fail to keep them in Ohio if lawmakers decide to expand,” Ingram added.

These observations, which Ingram backed up with data from Maine, Arizona, Massachusetts, and the National Center for Health Statistics, refute talking points from Republican Gov. John Kasich and the Ohio Hospital Association (OHA).

Expansion or Reform

Ingram’s study also offers several concepts for additional reforms Ohio could undertake instead of expanding Medicaid. Variations on several of the reforms he recommended are included in the Medicaid reform bill proposed by Rep. Barbara Sears (R-Monclova Twp.). Her proposal relies on the assumption Ohio could take billions in new federal funding by expanding Medicaid, but in the future “shall cease to cover the group, and any subgroup of the group” if “the federal medical assistance percentage for expenditures for Medicaid services provided to the group or subgroup is lowered.”

In a statement announcing the Ingram report, Opportunity Ohio President Matt Mayer said Kasich’s approach to Medicaid expansion is not an avenue to achieving real reform.

“The bottom line is that our elected officials should stand for real reform, not expanding a costly and broken program,” Mayer said.


Internet Resources:

Opportunity Ohio: Medicaid in Ohio—The Choice is Clear, by Jonathan Ingram