Budget ignores long-term care, health reform

Published 10:09 am Thursday, June 25, 2009

AARP Ohio is deeply concerned about two key issues that remain to be resolved as elected officials work to balance the state’s next budget – long-term care and health coverage reform.

Ohio must save Medicaid dollars by implementing a unified long-term care system that provides choices, and Ohio must enact health insurance market reforms that guarantee all Ohioans access to affordable private coverage.

The current budget shortfall puts both these priorities at risk.

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A unified long-term care budget allows Ohioans who need long-term care the choice of where they receive services. AARP surveys overwhelmingly show that individuals and families prefer to receive care at home or in options such as assisted living.

Changing the balance of Medicaid spending in Ohio from a reliance on nursing facility care to a stronger investment in at-home and community-based care is what unifying the budget accomplishes.

Three Ohioans can receive long-term care services in their own homes for the same amount of Medicaid dollars spent to care for one nursing home resident. Costs per client average $38 per day in the PASSPORT home care program compared to $166 per day in nursing homes.

The Ohio Business Roundtable’s recent study shows that Ohio has much to gain from re-balancing the system. It estimates Ohio could save $900 million per year if our Medicaid long-term care spending pattern matches the national average.

Health insurance market reform is our other budget concern. Currently some 1.4 million Ohioans lack health insurance, costing each family with insurance a hidden penalty of $1,017 last year to subsidize health care providers that treated uninsured individuals.

Reforming Ohio’s broken health insurance open enrollment program is critical in today’s economy because far too many mid-life Ohioans who lost job-based coverage are closed out of the market.

They can’t find affordable coverage because insurers consider age and pre-existing conditions when setting rates. Industry data show that insurers reject between 17 percent and 28 percent of applicants aged 50-64.

Right now, those who can find individual coverage through the open enrollment program on average pay premiums that are three times higher than rates paid for employer-based insurance while their out-of-pocket spending is more than twice that paid by those whose coverage is through their employers.

The original budget proposal contains sound policy on these two issues and produces savings both for the state and for individuals. AARP Ohio urges the Governor and General Assembly to include the unified budget for long-term care and health insurance market reforms in the next state budget.

Jane Taylor is the state director of AARP Ohio.