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Questionnaire NameHealthy Ohio Program
DescriptionOhio requests a new 5-year section 1115 demonstration which seeks to modify the existing Medicaid expansion program. Individuals eligible for this program include the new adult group and all other non-disabled Medicaid eligible beneficiaries age 18 or older up to 133 percent of the federal poverty level. Beneficiaries, except for pregnant women, must make monthly contributions to a health savings account equal to 2 percent of income but not exceeding $99 a year. Failure to make monthly contributions within 60 days from the due date will result in disenrollment. Beneficiaries may reenroll but must pay debt owed before reenrollment. Beneficiaries, except for pregnant women, are subject to copayments which are paid for through the contributions made to the account, provided the beneficiary has funds in the account. Beneficiaries can earn money to pay for copayments by completing specified health behaviors. The federal comment period will be open from July 8, 2016 through August 7, 2016.
Response FromID: #209517 on Jul 14th 2016 8:57 am
Healthy Ohio Program

Healthy Ohio Program

We encourage the public to submit their comments on Medicaid.gov as they relate to demonstrations open for public comments. In support of transparency and open government, all public comments received are immediately posted and are in the public domain. Center for Medicaid and CHIP Services staff will review all public comments posted and we reserve the discretion to delete comments that are generally understood as any of the following: obscene, profane, threatening, or otherwise inappropriate.

Refer to the Application

Open for Public Comment – 7/8/16 – 8/7/16

Please provide your comments here and/or attach below:

On behalf of the 4,800 family physician, family medicine resident and medical student members of the Ohio Academy of Family Physicians, I write to express extreme concern with the Ohio Department of Medicaid’s Healthy Ohio Program 1115 Demonstration Waiver application.
As primary care physicians serving on the front lines of patient care in Ohio, we know firsthand that approval of Ohio’s waiver application would be a devastating blow to progress made in providing health care coverage to Ohio’s Medicaid and other low-income populations. In fact, the Healthy Ohio Waiver, as written, threatens coverage of over one million adult Ohioans who now have coverage – a huge step backward rather than continuation of earlier progress made possible by the Affordable Care Act (ACA) and Medicaid expansion.
Premiums have been a feature of Medicaid’s waiver programs in other states and have consistently resulted in program disenrollment and participation decline. That means people are not getting the health care they need. Research also shows that the cost of administering nominal co-pays or premium payment programs far exceeds the value of the premiums or co-pays collected. Furthermore, Medicaid expansion has improved care by transitioning services from expensive hospital emergency departments to less expensive outpatient settings.
Supporters of the waiver application would have you believe that Ohio’s waiver proposal is very similar to the Indiana waiver that CMS approved. The truth is Ohio’s proposal is far more drastic and harmful as Ohio’s plan locks out all participants (except pregnant women) from basic Medicaid coverage if they are unable to pay premiums. Indiana provides participants with basic Medicaid coverage if they fail to pay premiums as long as they are at or below 100% federal poverty level or if they were unable to pay the premium due to domestic
violence, living in a county with a disaster declaration, being medically frail, and other exceptions deemed necessary. Ohio offers none of these exceptions.
The bottom line – the Indiana waiver decreased the number of uninsured individuals and increased the number of individuals with Medicaid coverage. Ohio’s waiver would do the exact opposite – increase the number of uninsured and decrease the number of individuals with Medicaid coverage. This is not the direction we want to head as a state or nation.
Please reject Ohio’s 1115 waiver application for what it is – another effort to dismantle the ACA.
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