Ohio released the language
of its proposal that would ask the federal government to approve a new work requirement for residents on Medicaid who gained coverage under the expansion of the program under the Affordable Care Act. Those over 55, in school, training for a job, in drug or alcohol treatment, dealing with serious mental illness or severe healthcare needs would be exempt. It will also request a waiver of the Obamacare requirement
that everyone have healthcare.
Indiana and Kentucky have already received approval for similar restrictions; other states, largely those with GOP-controlled legislatures and governors, are expected to follow suit.
Ohio expanded Medicaid under the ACA in 2014, a move championed by Governor Kasich.
709,923 Ohioans enrolled under the expansion. As Loren Anthes, a fellow with the Center for Medicaid Policy at the Center for Community Solutions, points out, Ohio, by its own estimates, says 95% of enrollees are already meeting the proposed requirements (working 20 hours a week) or would be exempt. Only about 36,000 individuals would currently be affected and the state would expect one half, or about 18,000, to lose coverage over five years.
Worth noting: A state report,
billed as the most comprehensive study of the expansion of Medicaid under the ACA, found that the majority of respondents said "enrollment in Medicaid made it easier to work, or to seek work if they were unemployed."
"Work requirements are redundant and unnecessary because most people are working. The problem is there aren't enough well-paying jobs," Wendy Patton, senior project director with Policy Matters Ohio, told the Columbus Dispatch.
Patton said that in Ohio, 61 percent of working-age Medicaid enrollees are working: 40 percent full time and 21 percent part time. Most of the rest, she said, are ill or disabled, in school, caring for someone or looking for work.
Work requirements can trip up low-wage workers because their hours often fluctuate. Those in jobs such as fast-food, retail and landscaping might have changing or seasonal hours, and under the proposed employment policy, workers who don’t get enough hours lose Medicaid coverage, making it harder to stay healthy and employed.
"This policy will end up kicking people out of medical care and making it harder for them to work, not easier," Patton said.
The proposal would include provisions for limited enforcement in counties with an unemployment rate of more than 10% or limited jobs.
More than 1 in 5 Ohioans are enrolled in Medicaid.
Ohio's target date for the work requirement is July 1, 2018.