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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: #210545 on Jul 18th 2016 11:36 am
Healthy Ohio Program

Healthy Ohio Program

We encourage the public to submit their comments on 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:

To Whom It May Concern:
Please accept this letter in opposition to the proposed Healthy Ohio 1115 Medicaid Waiver. The Toledo/Lucas County CareNet Board strongly believes the waiver will disrupt coverage and increase costs for Medicaid beneficiaries in Lucas County and beyond.

Toledo/Lucas County CareNet is a non-profit organization that has worked tirelessly since 2003 to reduce barriers to healthcare for residents living below 200% of the federal poverty level. CareNet formed a Charity Care Network that involves all 7 hospitals in Lucas County, plus 15 primary care clinics and more than 220 volunteer specialty care physicians. Since Medicaid was expanded in Ohio, CareNet has continued to provide coordinated access to care for those who remain uninsured. CareNet also provides care coordination to help reduce the social determinants of health and educate residents about how to use their coverage.

As a result of Medicaid expansion, 640,000 more Ohioans now have coverage. More than 2.9 million Ohioans, or 25% of the state’s population, are enrolled in Medicaid. The waiver would create the following changes for more than 1 million of Ohio’s Medicaid beneficiaries – and negatively impact recipients in Lucas County:

• Unaffordable premiums that have led to enrollment declines in other states. For example, enrollment dropped by 77% in Oregon after premiums were instituted.

• Termination of coverage for non-payment of premiums.

• The addition of health savings accounts and debit cards, which will be costly to administer and complex for Medicaid beneficiaries to use. Due to high administrative costs, Arkansas recently eliminated the imposition of health savings accounts and cost-sharing requirements on participants below 100% of the federal poverty level.
• Annual and lifetime caps, which were eliminated as a result of the Affordable Care Act. Medicaid recipients should not be subject to caps, which are now illegal.

These proposed changes would rebuild barriers to care that the state’s expansion had helped to tear down. Thank you for considering the Toledo/Lucas County CareNet Board’s opposition to the waiver.

Jan L. Ruma
Executive Director – Toledo/Lucas County CareNet
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