Partners in Freedom: Ohio’s Buckeye Institute Leads the Way on Medicaid Waivers and Other Health Care Reforms

Published April 6, 2020

After Obamacare was implemented, insurance companies started exiting Ohio, which left Ohioans with fewer insurance options and increased costs. Adding to the uncertainty, Ohio’s governor defied the state legislature and decided to expand Medicaid in 2013.

     “We warned that Medicaid expansion would be more expensive than the state was projecting,” said Rea S. Hederman Jr., vice president of policy and executive director of the Economic Research Center at The Buckeye Institute. “Now, Medicaid takes up one-fifth of the state’s budget and it’s growing.”

The Buckeye Institute recognized that Ohio—and other states—could take advantage of the Medicaid 1115 and Affordable Care Act (ACA) 1332 waivers to make the program more fiscally responsible and limit the damage of Obamacare. Waivers allow states to experiment with new approaches in meeting their coverage goals.

     Buckeye’s efforts to raise awareness about how states can use federal health care waivers put the organization in the national spotlight. In fact, in 2018, Hederman helped convince the Trump Administration to remove federal restrictions on the use of section 1332 waivers.

For that work, Buckeye was nominated for a 2019 Bob Williams Award for Outstanding Policy Achievement by the State Policy Network. Additionally, Ohio was among the first states to seek and get approval for a work requirement for able-bodied Medicaid enrollees. Buckeye’s leadership on these issues has led other states grappling with Medicaid expansion to seek Buckeye’s expertise and advice—Buckeye experts have been asked to testify in and write op-eds for Iowa, Tennessee, and Florida, among other states.

Comprehensive Health Care Reform

Medicaid reform is not the only area where Buckeye is putting an emphasis on free-market health care. It is pushing for better scope-of-practice laws so nurse practitioners and other mid-level providers can fully use their licenses to help Ohioans—something particularly vital for the state, which is facing a shortage of physicians in some communities.

    Buckeye has also helped push policies to encourage charity care as a way to improve primary care access. One such policy method has been to remove obstacles for charity organizations that wish to provide free, quick, short-term health care in communities where there is a particular temporary need.  Buckeye’s work has led to policies that allow health professionals in other states to offer that care as well.

Insurance is another area on Buckeye’s list of issues in need of reform. The organization, along with the Cato Institute, recently filed an amicus brief calling on the U.S. Court of Appeals for the District of Columbia Circuit to uphold a district court decision allowing for 12-month short-term, limited duration insurance plans (see related article, this page).

 As a result of Buckeye’s comprehensive efforts to reform health care, Ohio and other states now have an alternative to the previous one-size-fits-all federal health care policies, and consumers can enjoy more choice and flexibility.

AnneMarie Schieber ([email protected]) is managing editor of Health Care News.