Policy and partnership to advance health care.

Ohio’s health plans are major contributors to Ohio’s economy, innovators of programs to improve the health of Ohioans and avenues for individuals, employers, and the state to get the best value for the health care services they need. The Ohio Association of Health Plans (OAHP), which is comprised of 16 member plans, is the voice for Ohio’s health insurance industry. Our members provide health care coverage to more than 9 million Ohioans through the private, commercial coverage and are committed partners in public programs, such as Medicaid, the Health Insurance Exchange and Medicare.

Two-thirds of all U.S. adults use prescription drugs, at an average cost of $1,200 per year. High list prices, set by pharmaceutical companies, are driving up the cost of health care and hurting vulnerable Americans, especially the elderly. Among people 65 or older, 12% say they haven’t take all their prescribed medications in the past two years because of high costs. Among those 51 to 64, 25% reported rationing needed medications.

Since 2014, nearly 150,000 Ohioans who are eligible for both Medicare and Medicaid — many of whom are frail and elderly — have chosen to receive long-term supports and services through MyCare Ohio, a pilot project that brings the benefits of managed care to this especially vulnerable population. Now, the federal government has directed states with such pilot programs to either convert them to programs serving all dual-eligibles or end them by December 31, 2023. We support the Ohio Department of Medicaid proposal to transition MyCare to a program serving all Ohio dual-eligibles.

Prior Authorization is a necessary tool to help ensure patient care is safe, effective and affordable. In Ohio’s competitive health insurance marketplace, many insurers are developing gold-carding programs to attract the proven best-performing providers, by exempting them from prior authorization.