Nearly 3 million people in Ohio are covered by Medicaid (21% of the total population). While four in five (79%) of enrollees are children and adults, more than one-half (59%) of the state’s Medicaid spending is for the elderly and people with disabilities.
345,300 (17%) of Ohio’s Medicare enrolleesare also covered by Medicaid, which accounts for over two-fifths (41%) of Medicaid spending.
40% of all children in Ohio are covered by Medicaid, including 46% of children with special health care needs.
59% of nursing home residents in Ohio arecovered by Medicaid and 39% of Medicaid long-term care spending in Ohio is for nursing home care. Medicare beneficiaries rely on Medicaid for assistance with services not covered by Medicare, particularly long-term care.
88% of Medicaid enrollees in Ohio arein managed care. Since Ohio has already transitioned most enrollees to managed care, it would not be able to recoup much of the one-time savings that some states experience during that transition.
Ohio has a below average per capita income and therefore a relatively high federal Medicaid matching assistance percentage (FMAP) at 62.3%. For every $1 spent by the state, the federal government matches $1.65. Almost three quarters (72%) of all federal funds Ohio receives are for Medicaid. In Calendar Year 2017, the federal match rate for the Medicaid expansion population is 95%.
What is at Risk under a Per Capita Cap?
Capping Medicaid funding would reduce the federal assistance for Ohio to maintain its current Medicaid program.
Under the Better Care Reconciliation Act of 2017 (BCRA), to maintain its current Medicaid program, Ohio would have to make up $20.5 billion in loss of federal funds between 2020-2029, including $10.8 billion for the phase-out of the enhanced match for the ACA expansion and $9.7 billion for the per enrollee cap on all groups.
If Ohio dropped the Medicaid expansion in response to the loss of enhanced federal financing, the state would forgo an additional $32.8 billion over the 2020-2029 period, and by 2029, 858,000 Ohioans estimated to be covered in the expansion group would lose Medicaid coverage.
Capping federal Medicaid funding could put Medicaid programs designed to improve quality of life and access to new therapies and long-term care for people with disabilities at risk. 14% of Ohio’s non-institutionalized population reported a disability, compared to a U.S. average of 13%.
Reducing federal funds through a per capita cap or block grant would limit Ohio’s ability to respond to public health crises such as the opioid epidemic, HIV, or Zika.
Ohio had the third highest opioid death rate in the country in 2015 (24.7 deaths per 100,000 population).
Two-thirds (66.5%) of people in Ohio are overweight or obese and more than one-third (35%) report poor mental health status. Ohio’s population faces many health challenges, ranking 40th in overall health status.