Ohio lawmakers offer 2 bills to change Medicaid

REGINA GARCIA CANO Associated Press Published:

COLUMBUS, Ohio (AP) -- Proposed changes to the Medicaid program in Ohio are unlikely to clear the Legislature before lawmakers break at the end of the month, the Republican leader of the House said Tuesday.

Ohio legislators have been trying to find common ground on the federal-state health program for the poor and disabled people.

"My sense is that, at this point in time, we cannot complete that work, but we will continue the work," Speaker William Batchelder told reporters.

Republican Gov. John Kasich's proposed two-year budget initially called for expanding Medicaid. But GOP leaders stripped the idea from the House version of the state spending plan in April. Lawmakers face a June 30 deadline to complete the state's spending bill.

"This is not something that is going to stop just because everybody goes home on June 30," he said.

Batchelder, of Medina, said he had no time frame for finishing a Medicaid plan. He said legislators want to gather additional information. He told reporters he expects lawmakers will continue to focus on the issue even after the General Assembly adjourns for about two months.

An Ohio House committee on Tuesday discussed proposals to restructure the program. The chairman of the House Finance and Appropriations Committee, Ron Amstutz, who is the sponsor of one of the proposals, acknowledged that chances are slim that a bill will be approved before the Legislature recesses for the summer.

Amstutz's bill is aimed at curbing Medicaid costs and making the program more efficient. It would neither increase nor cut beneficiaries.

The measure has the backing of a bipartisan group of sponsors, who have described the legislation as a starting point for discussions on how to change the program and admitted the measure needs significant work.

The bill would create a Medicaid oversight committee. It also instructs the state's Medicaid director to limit the growth of the program's costs in a way that would improve the physical and mental health of recipients.

In addition, it calls for providing Medicaid beneficiaries "with information about the actual costs of Medicaid services and the amounts the Medicaid program pays for the services so that recipients are able to use this information when choosing Medicaid providers." Amstutz described this provision as a "cost-containment" strategy. He said it is "aspirational" that enrollees will choose the least expensive provider.

Other changes are aimed at removing barriers that impede a beneficiary's ability to transfer to lower cost Medicaid services. Lawmakers also want to cut down on the number of times Medicaid patients are re-admitted to hospitals or use the emergency room when it is avoidable.

Medicaid provides coverage for one of every five residents in Ohio. The expansion of the program nationwide is one of the key components of President Barack Obama's signature Affordable Care Act, which requires that nearly all Americans have health insurance beginning in 2014 or pay a penalty.

Last year, the U.S. Supreme Court gave states the right to reject the expansion without risking the rest of their federal Medicaid money.

Speaking to reporters at an event at the Statehouse, Kasich said an expansion of the Medicaid program is needed.

"It will either be in the budget or it'll be later," Kasich said. "But I just want to make it clear: I will not give up this fight till we get this done -- period exclamation point."

Another proposal presented at the committee hearing would extend Medicaid eligibility to cover thousands more low-income Ohioans. The bill from Republican state Rep. Barbara Sears would encourage cost sharing for new enrollees, such as copays and deductibles, and ensure that beneficiaries who abuse narcotics are unable to access the drugs through the health care system.

"We know some things about those whom we might see in an expanded population," Sears told the committee. "We could see underemployed, undereducated, addicted. We could also see disabled, veterans and those living with behavior or mental health issues."

Sears said her bill also aims at making Medicaid recipients assume "greater personal responsibility" for their care by incorporating health savings accounts.

Obama's health law intended for an expansion of Medicaid to cover people making up to 138 percent of the federal poverty line, or nearly $15,860 for an individual.

Roughly 366,000 Ohioans would be newly eligible for coverage beginning in 2014 by expanding Medicaid. The federal government would pay the entire cost of the expansion for the first three years, gradually phasing down to 90 percent -- still well above Ohio's current level of 64 percent.

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Associated Press writer Ann Sanner contributed to this report.

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Contact Regina Garcia Cano at https://www.twitter.com/reginagarciakNO