Medicaid expansion will remain a contentious issue for many more weeks as Ohio debates the next biennial budget. Advocates of expansion, a spectrum including Gov. John Kasich, hospital and business executives, continue to make a persuasive case for implementing the proposal. Appropriately, they emphasize the economic gains, the billions of dollars flowing into health services, the increased access to regular primary care and the opportunities for productive lives that will open up for those with challenging conditions, especially severe mental illnesses and alcohol and substance addictions.
State lawmakers need equally to keep in mind the impact on the well-being of families when the parents of minor children do not have health insurance and assured access to care. Child-welfare experts indicate that lack of health care is a significant contributor to stresses and dysfunctions in families, conditions that often underlie physical or emotional neglect and abuse of children.
In testimony on the proposed expansion, the executive director of the Public Children Services Association of Ohio noted, for instance, how children wind up in public care as a result of addictions and/or mental health issues of the parents.
As the caseloads of child-welfare agencies show, protecting children in dysfunctional families is an increasingly expensive long-term public commitment. Currently, Ohio Medicaid covers parents with incomes up to 90 percent of the federal poverty level, which leaves a sizable population of low-income working parents with little or no coverage. The expansion would cover individuals up to 138 percent, income of about $32,499 a year for a family of four. It makes sense, therefore, to ensure adequate health coverage to reduce the likelihood that the physical and mental-health problems of parents become liabilities for their children and, ultimately, for their communities.