Blog 1/10/25

Medicaid Work Proposal Risks Healthcare Access, Raises Costs for Ohio Taxpayers

COLUMBUS, Ohio – Over the winter holidays, the DeWine administration and the Ohio Dept. of Medicaid (ODM) proposed a new Medicaid work requirement. The proposal and updated waiver application could impact nearly 1 million Ohioans, based upon data from the U.S. Dept. of Health and Human Services (HHS).

In their own proposal, ODM notes that more than 60,000 existing enrollees will automatically become ineligible for Ohio Medicaid coverage. ODM also estimates that their proposal will increase the cost per member per month (PMPM) annually for at least the first five years of implementation. In other words, ODM intends to remove existing enrollees, restrict coverage eligibility, and increase costs.

Mel Clay (he/him), Associate Director of Financial Counseling at Equitas Health, said: “This news is alarming since it could greatly impact our patients, especially those who are unemployed and homeless. Adding barriers like this will only cause more delay of care and more uninsured Ohioans. We all deserve quality healthcare and the appropriate resources to achieve desired health outcomes. Equitas Health will continue to serve as a safe haven for equitable healthcare services and connect our patients to available coverage and assistance program options.”

Ohio’s previous attempt to enact a Medicaid work requirement was set to go into effect during the COVID-19 pandemic. But in 2021, the Centers for Medicare & Medicaid Services (CMS), under the direction of the Biden administration, withdrew the approval. However, some fear that CMS, under the direction of the incoming Trump administration, may eagerly approve ODM’s latest proposal.

While increasing costs for Medicaid enrollees, and passing that cost along to Ohio taxpayers, the proposed Medicaid work requirement may also drive up healthcare costs for those with other forms of insurance.

Rhea Debussy, PhD (she/her), Director of External Affairs at Equitas Health, said: “Across multiple states, Medicaid expansion has led to lower premiums for health insurance plans on the marketplace. Shrinking Medicaid eligibility, via a work requirement, is expected to have the opposite effect, and this proposal may lead to even higher healthcare costs for everyone.”

Equitas Health strongly opposes any attempt to shrink Medicaid eligibility. The agency has already submitted a public comment to the DeWine administration and ODM. Equitas Health calls upon the broader community to submit public comments in opposition to this dangerous proposal.

Public comments must be received by 5 PM on Tuesday, January 21, 2025. You can submit your public comment:

• By email to GroupVIII@medicaid.ohio.gov or

• By mail to Group VIII 1115 Waiver, Bureau of Health Plan Policy, Ohio Dept. of Medicaid, 50 W Town Street, 5th Floor, Columbus, OH 43215.

More information is available here.