Those who support the expansion of Medicaid in Ohio are prone lately to watching carefully for hints that Republicans in charge of the legislature may be ready to advance the concept. Thus, it was encouraging to see state Sen. Dave Burke put the emphasis on “fact-finding” during an informational hearing of the special Medicaid subcommittee last week. “Let’s talk about facts,” the Marysville Republican stressed.
Add the imperative of Keith Faber, the Senate president, that Medicaid “reform,” or expansion, only go forward if it is financially feasible, and the hearing made more compelling the opportunity for the state to improve the quality of life for many Ohioans in need of regular health coverage.
The panel heard from two analysts with as solid of a grip on the subject of Medicaid as almost anyone in the state. Amy Rohling McGee of the Health Policy Institute of Ohio and Bill Hayes of Ohio State University reported on the results of tasks they had received from lawmakers.
They were asked to compare spending projections for Medicaid, one without the expansion, the program growing at its current annual rate, and the other with the expansion, the program growing at a yearly rate similar to the three-year average for medical inflation.
What did they find? Total Medicaid spending — without expansion — will reach an estimated $43.4 billion in 2025. (It currently stands at roughly $18 billion.) And under the scenario that includes the expansion? Total spending would climb to as high as $39.5 billion in the same time frame.
Worth adding is that these figures account for state and federal contributions to the Medicaid program. McGee and Hayes looked at state money alone, now around $7 billion a year, and found a similar trend. Without the expansion, the program would reach $17.4 billion in 2025. With the expansion, the sum would be $14.2 billion.
And if the feds renege on covering 90 percent of the cost of the expansion, returning to the standard 60 percent? The tab for Ohio would be $15.8 billion, or still less than the expense of the program operating in its current form.
None of the numbers is certain or exact. They do reflect highly educated assessments, revealing trends under the scenarios, showing that contrary to much rhetoric around the Statehouse, the expansion is feasible financially. Or as Sen. Burke put it, the numbers are “obtaintable.”
As part of their task, McGee and Hayes also recommended ways to move Medicaid spending “toward sustainability and predictability.” They pointed to measures such as emphasizing quality of care over quantity of procedures, plus focusing on prevention. The striking thing is their concepts fit into the pattern pursued by Gov. John Kasich and his team, the efforts to remake Medicaid setting a strong platform for affordable expansion.