As pandemic-era policies and benefits end, Ohio officials estimate as many as 280,000 of the 3.55 million enrolled Ohioans may lose Medicaid.
Approximately 1 million Americans have already lost coverage from the government-paid health insurance program for children, low-income adults, seniors and those with disabilities since federally mandated automatic re-enrollment in the program ended on March 31, including 24,000 Ohioans who have lost the benefit since the end of May, according to the Ohio Department of Medicaid.
Now, people must manually re-enroll to get coverage.
Meanwhile, Ohio is one of the states that spends the most on insuring its citizens, but it doesn’t measure up in terms of health care access and quality.
How Ohio’s Medicaid spending compares to other states
Ohio spent $27.6 billion on Medicaid, ranking sixth in the nation for spending, according to 2021 data, the most recent available from the Kaiser Family Foundation, a nonpartisan health policy organization.
Ahead of Ohio in spending are California (ranking number one at more than $100 billion), New York, Texas, Pennsylvania and Florida. Each state ranks higher than Ohio when it comes to total population. Ohio’s population is the seventh-highest in the nation.
Total Medicaid spending in the nation was $748 billion in 2021, according to the foundation.
But when it comes to the population’s overall health, Ohio is almost at the bottom — 44th out of the 50 states, according to the Health Policy Institute of Ohio. This is measured by a number of factors, including physical activity of the population, consumption of alcohol, suicide, depression, infant mortality, life expectancy, chronic illness and more. By comparison, California is ranked at third best.
“We have less healthy lives here in Ohio and we’re spending more on health care than people in many other states,” said Edith Nkenganyi, a policy analyst at the Health Policy Institute of Ohio, who worked on its 2023 Health Value Dashboard for Ohio.
“That’s not good,” said Amy Rohling McGee, the policy institute’s president. “We have a lot of room for improvement.”
What is Medicaid and how many Ohioans have it?
Medicaid is a public health insurance program for those who can’t afford their own and, in Ohio, it’s the largest single insurer in the state, according to Policy Matters Ohio, a nonprofit research institute.
To qualify for Medicaid in Ohio, a one-person household would have to have an annual income of less than $19,392 before taxes.
The Medicaid program, which is a partnership between states and the federal government, covers different things in different states, though all states are required to pay for certain federally mandated services for their residents.
About 3.55 million people, or 30% of Ohioans have Medicaid, making it “an essential way in which people are able to access care,” according to Rohling McGee and the policy institute’s 2023 Ohio Medicaid Basics Report, released in May.
Most of those people, more than 1.33 million, are children.,
Medicaid also accounts for a large proportion of state money, with about 39% of the state’s $110 billion budget going to the program in 2022, according to the institute.
Why does the state spend so much money on Medicaid?
During the COVID-19 pandemic, from February 2020 to December 2022, Ohioans getting the federal benefit grew by 29.6%, from 2.5 to 3.3 million, according to the Kaiser Family Foundation.
That’s in part because, when the COVID-19 public health emergency began, the federal government started automatically re-enrolling people on Medicaid, and many also became unemployed during the pandemic. Ohio’s enrollment growth during the pandemic was the 6th largest, with 837,600 people enrolling.
The Ohio Department of Medicaid said it is referring those who lose benefits because they are being found ineligible post-pandemic to navigators and managed care providers who can help them find alternative health care coverage that is affordable.
Other pandemic-related programs are expiring or changing concurrently, Rohling McGee said, including food stamps, and that could also have an impact on people’s ability to access fresh and healthy food and increase financial stress.
“We want to make sure that programs like Medicaid do stay in place,” said Rohling McGee.
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