Kasich going after Medicaid

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Kasich going after Medicaid
He asks Obama to let Ohio cut enrollment but keep federal aid
Saturday, January 8, 2011  02:50 AM
By Catherine Candisky

The Columbus Dispatch

John Kasich and leaders from 32 other states signed the letter.Gov.-elect John Kasich and 32 other Republican governors and governors-elect are urging the Obama administration to let states cut enrollment in the tax-funded Medicaid program without losing federal aid.

In a letter yesterday to the president and congressional leaders, the GOP leaders urged them to abolish a stipulation in the health-care law that cuts federal aid to states that drop people from Medicaid, the state-federal health-care program for the poor.

"The effect of the federal requirements is unconscionable," Kasich and the others wrote. The rules "force governors to cut other critical programs, such as education, in order to fund a 'one-size-fits-all' approach to Medicaid."

Medicaid enrollment in Ohio and across the nation has soared since the recession began. More than 2 million Ohioans get health coverage through the program, with costs now topping $15 billion a year.

"It's a reasonable ask for many cash-strapped states," said Kasich spokesman Rob Nichols.

State officials are projecting an $8 billion shortfall in Ohio's next two-year budget, which takes effect July 1.

But advocates say slashing Medicaid rolls is a bad idea that will increase the ranks of the uninsured and hurt Ohio's economy. Medicaid spending creates health-care jobs and generates income in other sectors as well, they contend.

"We have fought long and hard for many years to get Medicaid eligibility where it is today, and it's not that high," said Col Owens, co-chairman for Ohio Consumers for Health Coverage.

Under Ohio guidelines, children and pregnant women in households earning up to 200 percent of the federal poverty level are eligible for coverage. That's $21,660 a year for an individual and $44,100 annually for a family of four.

On the low end, senior citizens and nonworkers with disabilities with incomes up to 64 percent of the poverty level can get benefits. That's $6,931 a year for individuals.

"If we lower Medicaid eligibility, we lose services for people in need and we lose federal Medicaid dollars coming into the state," Owens said.

"While it might look on the surface as a way to save money, it costs services and jobs."

The federal government provides matching funds covering about 60 percent of Medicaid costs, and states pick up the rest. So, for every dollar Ohio cuts in Medicaid spending, it will lose an additional $2 in federal aid.

That's money spent on doctors, nurses, hospitals, nursing homes and other care providers. State officials say Medicaid now makes up more than 3 percent of Ohio's economy.

The governors and soon-to-be governors are especially concerned about federal "maintenance of effort" regulations. Under the requirements, states that reduce eligibility or make it more difficult to enroll will lose federal aid.

Some states have raised the possibility of withdrawing from Medicaid entirely and establishing much smaller state programs because of budget constraints.