A doctor looks at an x-ray indicating lung cancer. (Stock photo from Getty Images.)
Proposed Medicaid work requirements mean more than 61,000 Ohioans could potentially lose their health insurance, if the incoming Trump administration allows Ohio Republican state leaders to proceed with their plan.
While the Biden administration has stood in the way, Ohio’s 2023 budget signed by Gov. Mike DeWine requires the state Medicaid department to re-apply with the federal government under the new presidential administration for permission to impose work, drug testing, and/or education requirements for adult Medicaid health coverage recipients.
A goal of this requirement is “promoting economic stability and financial independence,” according to the Ohio Department of Medicaid.
Work requirements for Medicaid would have the opposite effect, said Will Petrik, director of policy and advocacy at Rise Together Innovation Institute.
“This proposal will take health care away from thousands of people who are struggling to make ends meet,” he said. “This proposal is going to reduce access to Medicaid, that will leave residents sicker and more vulnerable.”
The state is currently undergoing a comment period on the new requirements before submitting them to the Centers for Medicare and Medicaid Services. Anyone who wishes to comment on the new proposed requirements can email the Ohio Department of Medicaid at GroupVIII@medicaid.ohio.gov until Jan. 21 at 5 p.m.
“It kind of leads to this mentality that this is going to help people pull themselves up by their bootstraps,” said Kathryn Poe, health and budget researcher at Policy Matters Ohio. “When the thing that actually pulls people up by their bootstraps is health insurance and housing and all of these other social benefits have to be in place before you can work, not after.”
The Ohio Department of Medicaid estimates 61,826 would lose their health insurance if these changes were to take effect, a number Poe and Petrick think is low.
“I think that they’re going to hit more administrative issues than what they can estimate,” Poe said.
Showing proof of work can be challenging if people don’t have reliable access to the internet, Petrick said.
Poe is worried people who are sick or disabled and can’t work will have a hard time proving to the state that they are unable to work.
“People often need health insurance to get that diagnosis to prove that they have a disability,” Poe said. “It’s just very messy. … We’re creating this system in which Ohioans are very uncertain about the future of their health insurance if they’re using state benefits. The ability to have health insurance is one of those primary cornerstones of economic stability.”
A lot of people who get kicked off of Medicaid do not re-apply, Poe said.
“You often have to fight your way back into the system, and not everybody has the time or the money, or, quite frankly, just the emotional energy to try to fight your way back into the system,” Poe said.
People typically start to accrue medical debt when they lose their health insurance.
“If you have someone who’s kicked off of Medicaid who has Type 1 diabetes, that person still has to go in and get their insulin every month, they’re just going to keep racking that number up until they can get health insurance again,” Poe said.
Georgia and Arkansas have tried to implement Medicaid work requirements, but faced various challenges.
“It doesn’t work because it requires a lot of administrative lift for the state to actually go in and verify that someone is working,” Poe said.
A federal judge put Arkansas’ program on hold in 2019, but not before 18,000 adults lost their health insurance.
Georgia launched the Georgia Pathways to Coverage program in July 2023 that offers Medicaid coverage to low-income, working adults, but enrollment has fallen well short of expectations. More than 40% of Georgia’s counties had less than 10 enrollees, even though the state had one of the highest percentages of uninsured populations in the country, according to the Georgia Budget and Policy Institute.
Members of the Senate have asked the Government Accountability Office to investigate the Georgia Pathways to Coverage program.
Follow OCJ Reporter Megan Henry on Bluesky.
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