Medicaid reforms give patients more options

Published 12:00 am Wednesday, April 9, 2008

There were two important announcements recently that could have a significant impact on the stability of Ohio’s Medicaid system, the financial health of our state and the quality of care that thousands of Medicaid recipients receive each year.

In July 2006, as part of an effort to expand long-term care options for Ohioans, the state launched the Assisted Living Medicaid Waiver Program, which helps low-income adults cover the cost of care in an assisted living facility — a less expensive alternative to nursing home care that provides residents with needed services in an independent, home-like setting. At the time, eligibility for the program was limited to individuals living in nursing homes or enrolled in another home and community-based waiver program, such as PASSPORT, Choices and Home Care.

Unfortunately, as of this past week, only a fraction of the 1,800 slots available were filled.

Email newsletter signup

These low enrollment numbers became an important topic of discussion during the drafting of House Bill 119, the most recent state budget, and, eventually, led to language being inserted in the bill to expand eligibility for the program. In late February, the federal Centers for Medicare and Medicaid Services (CMS) approved these reforms, which allow current assisted living residents, who have spent down their financial resources and now qualify for Medicaid, to apply for an assisted living waiver. Under the old guidelines, these folks would have had to move to a nursing home to get the care and insurance coverage they need.

Although Ohio’s nursing homes surely serve an important role in the state’s long-term care, it just makes sense that we would allow those individuals already receiving care in an assisted living facility to stay there should they exhaust their finances and be forced to go on Medicaid. Not to mention, assisted living provides quality care at less cost to the state than nursing homes, potentially saving millions in taxpayer dollars each year.

In other important news, the CMS put a rubber stamp on Ohio’s long-sought Medicaid Buy-In program, which gives disabled Ohioans the opportunity to work without fear of losing their health care coverage. For years, the disabled were discouraged from working, because, if they reached a certain income level; they would lose their Medicaid benefits.

In a win-win for the state’s economy and the strength of our workforce, the Buy-In program, which has been championed by legislators during past General Assemblies and, finally, gained bipartisan approval as part of House Bill 119 last summer, allows Ohioans with disabilities to keep their jobs by paying a premium into Medicaid based on their salary.

For more than four decades, Medicaid has provided needed financial support for millions of low-income and medically vulnerable Ohioans, and we must continue to work to ensure these folks have access to quality care options. At the same time, Medicaid is growing at an alarming rate, and in order to avoid having to make cuts to needed services, we must work to rein in costs.

I believe the Assisted Living Waiver and the Medicaid Buy-In program help strike this important balance.

John A. Carey is a member of the Ohio Senate and represents the 17th District.