Not expanding Medicaid will cost far more

Published 12:10 am Sunday, September 8, 2013

States now can choose to cover more citizens through Medicaid. The Affordable Care Act creates a new category of Medicaid benefits which will cover adults whose yearly income falls below 138 percent of the federal poverty level (about $15,800 for a single individual).

Ohio lawmakers have not approved this change.

Many are concerned about the costs to Ohio if Medicaid is expanded. There are also costs to Ohio if Medicaid is not expanded. For expanded Medicaid, the federal government will pay 100 percent for 2014, 2015 and 2016. After 2016 the federal match decreases on an annual basis to not less than 90 percent by 2020 and in later years. This “enhanced match” for expanded Medicaid exceeds the current rate of 64-65 percent.

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If Ohio doesn’t expand Medicaid, the state will not get the higher federal match. Just by delaying expansion, Ohio has the potential to lose months of 100 percent federal match money. Instead of getting the projected amount of $23.8 billion in additional federal funds flowing into Ohio’s economy through 2019, Ohioans’ federal taxes will go to pay for expanded Medicaid in other states.

A recent study by Ohio State University and the Health Policy Institute of Ohio, with others, concluded that Medicaid expansion will have a positive economic impact on every county in Ohio. With more funds paying for more health care coverage locally, employment is projected to increase especially in the areas of ambulatory health services, hospitals, insurance carriers, administrative and support services, construction and retail trade. The increased economic activity generated is expected to result in increased local general sales tax income. In Lawrence County, the projected new local general sales tax revenues in 2015 due to Medicaid expansion amounts to $87,040.

In addition to these community economic benefits, with Medicaid expansion, every county will see an increase in uninsured residents receiving health care coverage. Lawrence County could see a 75 percent decrease in uninsured adults if Ohio expands Medicaid.

It is generally accepted that those lacking health insurance or the money to pay for medical care, may put off going to the doctor, filling a prescription, or delay treatment until a condition becomes a health catastrophe.

Those who are forced to wait until an emergency to treat a standard medical problem will likely need the very expensive services of a local hospital emergency room. Because the hospital is often uncompensated directly for that expensive care, the general population of Ohioans will experience higher insurance rates, cost shifting, higher fees, and the cost of emergency, instead of preventative care.

Medicaid expansion will allow preventative care and reduce the use of emergency rooms for what are otherwise basic health problems.


Mark J. Cardosi is the managing attorney with the Southeastern Ohio Legal Services, Portsmouth office. He can be reached at (740) 354-7563.