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CMS approves Ohio's plan to extend Medicaid coverage

CMS approves Ohio's plan to extend Medicaid coverage

On September 26, 2013, the Ohio Medicaid director submitted a State Plan Amendment (SPA) seeking to extend Medicaid coverage. On October 10, 2013, the federal Centers for Medicare and Medicaid Services (CMS) approved Ohio's SPA. As a result, federal funds are available to extend Medicaid coverage in Ohio beginning January 1, 2014.

Ohio Medicaid requests Controlling Board approval to extend coverage

On October 11, 2013, the Ohio Medicaid director submitted a Controlling Board request seeking authorization to spend federal-only funds to extend Medicaid coverage. Controlling Board approval on October 21, 2013 is the only action that is required to extend Medicaid coverage in Ohio beginning January 1, 2014.

Ohio's authority to extend Medicaid coverage

State Plan Amendment

Controlling Board request

Benefits of extending coverage 

Support for extending coverage

Recent Medicaid reforms

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Ohio Governor Moves To Put Medicaid Expansion Decision To Controlling Board.

The Columbus (OH) Dispatch (10/11, Vardon) reports Gov. John Kasich will seek permission from an oversight panel to expand Medicaid on Oct. 21. He requires the Controlling Board’s approval to spend about $2.56 billion in Federal money to cover approximately 275,000 low-income residents. One leading Republican board member, Rep. Ron Amstutz of Wooster, criticizes the move, citing “grave concerns about the place, the time and the substance of this proposed Controlling Board action.” The expansion would likely bring around $13 billion in Federal money over seven years. Ohio received the Obama Administration’s approval on Oct. 10 to expand Medicaid, and pending Controlling Board approval, the state could extend coverage as early as Jan. 1.

        The Toledo (OH) Blade (10/12, Provance) reports Ohio will request a total of $561.7 million in Federal funds between Jan. 1 and June 30, 2014, and $1.99 billion from then until June 30, 2015. The Controlling Board panel includes four Republican and two Democratic lawmakers plus one Kasich appointee, meaning if the two Democrats vote “yes,” one Republican vote will still be necessary. The paper does not expect any of the Republican legislators to vote “yes,” although it acknowledges “House and Senate leaders have been known in the past to change the makeup of a panel, if only for one meeting, to ensure a desired result.” However, there is some controversy over utilizing the panel to approve this initiative, as the Controlling Board can change Federal fund appropriation levels, but such a move “has to be consistent with the General Assembly’s intent,” according to 1851 Center for Constitutional Law Director Maurice Thompson.

        The Cleveland Plain Dealer (10/11, Higgs) reports many of Ohio’s major hospitals, physician organizations, church coalitions, healthcare advocacy groups, labor unions and business organizations support the Governor’s initiative. Republican legislators refusing the expansion cite reasons like opposing any major expansion of public support programs, concern about size of the national debt, and general opposition to the ACA. However, the administration has been preparing for expansion so that it could be ready for Jan. 1, “just in case.” Additional coverage was provided by the AP (10/14, Sanner), Reuters (10/12, Palmer, Ingles), The Hill (10/11, Viebeck) “Healthwatch” blog, the Huffington Post (10/11, Young), the Daily Caller (10/12, Antle), the Cleveland Plain Dealer (10/13, Suddes), the Zanesville (OH) Times Recorder (10/12, Thompson), and a New Philadelphia (OH) Times-Reporter (10/13) editorial.

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