Testimony: Medicaid – Barriers to care in the operating budget

Testimony before the Senate Finance Committee (House Bill 49)

Policy Matters Ohio’s Wendy Patton today delivered a statement to the Senate Finance Committee on House Bill 49, asking to protect the Medicaid expansion, but without barriers to care: work requirements and premiums.

“Some say premiums are needed for Medicaid services so low-income enrollees have some ‘skin in the game.’ They already do. On average, they contribute nearly twice the share of their income in state and local taxes as the top 1 percent,” said Patton.

Nearly a thousand people protested to the Centers for Medicare and Medicaid Services last year against the “Healthy Ohio” waiver proposal which included premiums on adult Medicaid enrollees. The waiver was rejected. Premiums are proposed again in House Bill 49 for Medicaid enrollees earning between 100 percent of the federal poverty line ($11,880 a year or $990 a month for a single adult without children) and the income ceiling of 138 percent of poverty ($16,400 or $1,367 a month for a single adult.)

For people on very limited incomes – like those on Medicaid – premiums decrease use of health care services. Low-income individuals are especially sensitive to increases in medical costs. Modest co-payments can reduce access to necessary medical care.

Work requirements have been found to be either ineffective or harmful. They have generally been unsuccessful in increasing long-term employment.

“Charging premiums and imposing work requirements pose barriers to health care and as such will prevent Ohioans from getting ahead through better health,” Patton said.

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Policy Matters Ohio is a nonprofit, nonpartisan state policy research institute with offices in Cleveland and Columbus