A Collaboration of Champions for Ohio Medicaid

This spring, I had the inspiring experience of helping lead a remarkable effort to protect health care for hundreds of thousands of vulnerable Ohioans. For three months — April, May and June — a powerful coalition of groups focused on health care and public health came together with the shared goal of preventing a catastrophic loss of Medicaid coverage for more than 770,000 people.

That’s how many Ohio residents are eligible for Medicaid coverage only because the state in 2014 opted to expand coverage under the terms of the Affordable Care Act. Expansion has helped raise our state’s health insurance coverage rate to historically high levels, with the federal government paying 90% of the cost.

That coverage faces a threat: Language in the new, two-year state budget says that, if the federal contribution, known as FMAP (federal medical assistance percentage) for the expansion population is ever lowered below 90%, Ohio will drop Medicaid expansion.

The Ohio Medicaid Matters (OMM) coalition came together to ask lawmakers to soften that so-called “trigger language” — to have it say expansion may be dropped if the FMAP falls, rather than shall be dropped. Failing that, we advocated for language to guarantee a “glide path” — a gradual, orderly end to expansion coverage rather than immediate cessation.

While we unfortunately were unable to secure a change in the language, I’m proud of the work OMM did and the collaboration it represented. I was thrilled to see 120 organizations, encompassing everything from major academic health systems to local social service agencies and statewide advocacy groups, join and meet regularly to build and execute our strategy. Together, they represented hundreds of thousands of employees, consumers and patients.

With funding support from our member health plans and a few other generous partner organizations, OAHP played a central role in convening the players. We helped ensure that lawmakers heard a consistent message through coalition members’ testimony at numerous budget hearings. Through that testimony and media accounts of OMM’s work, we helped shine a light on what Medicaid coverage means for real Ohio families and the state economy.

Fortunately, the recently passed federal spending bill did not reduce the FMAP below 90%. That means the trigger language in Ohio’s budget remains untriggered and Medicaid expansion in Ohio stays in place for now. While the Medicaid coverage for these 770,000 Ohioans is protected, I’m confident those 120 members, including OAHP, will remain vigilant to any future developments that could threaten this lifeline for Ohio families in need.

Ohio has made tremendous progress on public health goals in the past 10 years, thanks in no small part to Medicaid expansion. We’ll work hard to keep from going backwards.