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Medicaid

Medicaid is a joint federal/state program, established in 1965, that provides health insurance to eligible low-income and medically vulnerable populations. Ohio Medicaid and other government health insurance programs provide a safety net for specific populations that might otherwise have difficulty obtaining coverage.

To be eligible for federal funds, Ohio Medicaid and other state programs are required to provide coverage to certain groups of individuals and can choose to extend coverage to other categorically needy groups. While there are over 25 different eligibility categories for which federal funds are available, these groups are often classified into two broad groups: covered families and children – comprising eligible parents, children and pregnant women – and the aged, blind and disabled (ABD) population.

Ohio Medicaid Funding

Ordinarily, in Ohio, the federal government would pay 62 percent and the state government would pay 38 percent of Medicaid costs. However, as part of the American Recovery and Reinvestment Act of 2009, which included economic relief provisions for states, the federal government’s percentage on Medicaid expenses in Ohio went up to 70.3 percent through the end of calendar year 2010, resulting in a corresponding decrease in the state’s share. This assistance was welcomed by the state, however, it does not address a looming challenge. As Medicaid continues to absorb ever larger portions of both state and federal budgets, there is growing concern about the future affordability of the program.

Ultimately, the challenge is that controlling costs is not straightforward when it comes to Ohio Medicaid and other state Medicaid programs. While policymakers can decide to limit spending, the health needs of the population do not go away. Spending may be cut in one area only to resurface as an increased expense in another area. Cut eligibility, for example, and people who have lost access to primary care turn to hospital emergency rooms, oftentimes with more expensive health problems after having put off seeking care.

Looking to the future, passage of federal health reform will have a significant impact on the Medicaid program. Starting in 2014, Medicaid coverage will be extended to nearly all individuals under the age of 65 with incomes up to 138 percent of the federal poverty line (133 percent of the federal poverty line plus a 5 percent income disregard). This new mandatory minimum eligibility criteria is expected to add millions of new enrollees to the Medicaid rolls and decrease the number of uninsured in America. 
Last Updated: August 2010