Will Ohio embrace Trump’s Medicaid plan? Lawmakers’ reactions are mixed.

The Ohio Statehouse seen from the south

Whether Ohio will embrace the proposed Medicaid block grant program remains to be seen. Lawmakers have mixed reactions to it. (Laura Hancock/cleveland.com)

COLUMBUS, Ohio – State Republican lawmakers, who have a supermajority in the Ohio General Assembly, said Thursday they want to learn more about the proposal out of Washington to cap a portion of Medicaid dollars.

President Donald Trump’s administration announced a new Medicaid program called Healthy Adult Opportunity, which would be voluntary for states. It would dole out health care bucks in the form of a block grant – or capped amount of dollars – for non-disabled adults aged 65 and younger.

Medicaid is a joint state-federal health care program for disabled and low-income adults, which has about 2.8 million Ohioans receiving benefits.

Trump’s plan is a dramatic change to how Medicaid has been funded since 1965, when President Lyndon B. Johnson signed a bill creating it and Medicare for older Americans as part of his Great Society initiatives.

The decision on whether Ohio were to switch to block grant funding would fall on the administration of Gov. Mike DeWine.

The legislature could force Ohio Medicaid to take a block grant, as it did when it imposed the department to create work requirements.

Department of Medicaid Director Maureen Corcoran was noncommittal about block grants.

“The block grant program released today by the Centers for Medicare and Medicaid Services demonstrates the federal government’s openness to try new approaches to supporting our members,” said Corcoran in an emailed statement. “CMS has been a partner to Ohio Medicaid as we work through program improvements and move toward a re-imagined, person-focused health care delivery model for Ohio’s 2.7 million members.”

In the General Assembly, 10 lawmakers belong to the Joint Medicaid Oversight Committee, which closely tracks the state agency since it’s the largest expense in Ohio’s budget, as it is in most other state budgets.

Sen. David Burke, a Marysville Republican who is the committee’s vice chair, said he wants to exercise caution before embracing a block grant model, which would likely affect the 600,000 Ohioans who are enrolled through the Medicaid expansion made possible through Obamacare.

If the program just changes how money is sent to Ohio, he’s not interested. He said it would be a problem because if a person qualifies under federal law for Medicaid, then they’re entitled to it and there will be lawsuits if people don’t receive health care, he said.

“What happens if a state is not effective at delivering those benefits, runs out of money before the next block grant, and the patient is still entitled to the benefit?” asked Burke, a pharmacist. “Who would pay for it?”

On the other hand, Burke said he is interested in what the program provides Ohio Medicaid to pay for services that aren’t directly health care, but are strongly tied to health. For instance, he would like Ohio Medicaid to be able to help people with child care, housing and transportation.

“You ask the federal government to free up federal dollars, so we could put more into daycare and less into dental,” he said as a hypothetical. “You develop a pathway that meets that person’s needs.”

Rep. Mark Romanchuk, an Ontario Republican and chairman of the oversight committee, said he needs to study details.

“Generally, I’m always going to be in favor of block grants because of the flexibility it gives the states,” he said. “Because when we want to make changes we have to go to (the federal government) to get it approved. With a block grant it that means we’ll get more flexibility.”

Ohio Sen. Bill Coley, a Cincinnati-area Republican and a member of the Medicaid oversight committee, is enthusiastic about Trump’s program.

“It sounds perfectly situated for Ohio,” he said.

Sen Nickie Antonio, a Lakewood Democrat who is the committee’s ranking member, opposes block grants because she thinks they’re illegal.

The Trump administration says its goal with the block grants is to control Medicaid costs, but Antonio believes people will ultimately lose health care.

“When we expanded Medicaid in the state of Ohio, the data showed people got healthier,” she said. “People get healthier when you make health care and mental health and addiction support services and treatment services available to people. They get healthier and then they can go on to be more fully employed. When you take away these things and when you punish people, that does not happen.”

She noted the Ohio Medicaid is trying to clean up some issues with payments and its computer system and the number of uninsured kids is falling. She’d prefer the state spend energy addressing those matters, she said.

Other Ohio Medicaid stories:

State reveals $1.2 billion Ohio Benefits system riddled with defects a year out from Medicaid work requirements

Number of uninsured Ohio kids increases by 28 percent – 7th highest jump in U.S.

Ohio lays out how it will implement Medicaid work requirements: Capitol Letter

Planned Ohio Medicaid work requirements call for case workers to contact recipients before they’re cut off

Ohio Medicaid enrollment for children and adults is falling. 6 possible reasons why.

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