Analysis: Truth Squad breaks down what big cuts to Medicaid could mean here

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Today's topic: Breaking down the local impact of the big cuts proposed to Medicaid.

Why? Earlier this month, House Republicans signed off on their plan to replace the Affordable Care Act. The bill’s most sweeping changes are aimed at Medicaid, the state-federal health care program that locally provides coverage for tens of thousands Greater Cincinnatians. As the Senate considers its own version of the bill, here is a look what the wished-for changes to Medicaid could mean here.

But first, some helpful background:

Before the Affordable Care Act, Medicaid was mostly limited to adults who earned 90 percent of the federal poverty level (that’s not much, as you’ll see here) and also were parents, pregnant or disabled. Single adults were excluded from coverage. That last part is really important.

After the health law was passed, Ohio was among 31 states that opted to expand Medicaid to adults (including single adults) ages 19 to 64 that earned 138 percent of the poverty level or less. Now, a single adult whose income $16,394 or less qualifies for Medicaid in Ohio.

Since the ACA went into place, more than 700,000 Ohioans have enrolled into Medicaid coverage. Of those folks, 95 percent had no private insurance option open to them prior to enrolling, according to a recent study by two public health policy professors at The Ohio State University.

What’s been proposed?

Under the House Republicans American Health Care Act, Medicaid expansion would be rolled back starting in 2019 in two key ways: First, new enrollment into Medicaid by single adults and families earning up to 138 percent of the federal poverty rate would end. Secondly, those who are already enrolled under the expansion can stay on Medicaid, but should they ever fall out of the program for eligibility reasons, they’re out permanently. That’s because the federal government will cut off federal reimbursement to states for anyone who falls off Medicaid rolls.

Here’s a look at who's at-risk locally

As of last month, more than 91,200 residents across Adams, Butler, Brown, Clermont, Hamilton and Warren counties could be impacted. Here’s a breakdown by county:


West and Southwest   Total newly enrolled       % of population
Ohio counties               into Medicaid
  
Adams                          2,035                             7.13%
  
Butler                           19,325                            5.25%
  
Brown                          2,634                              5.87%
  
Clermont                      8,039                              4.07%
  
Hamilton                      54,378                            6.78%
  
Warren                        4,884                              2.30%
   
Total:                           91,295                            5.5%

Source: Ohio Department of Medicaid and U.S. Census
   
What’s next?

Several Republicans, including Senator Rob Portman, have said they’re not thrilled with the House plan.

“I don’t support the House bill as currently constructed because I continue to have concerns that this bill does not do enough to protect Ohio's Medicaid expansion population, especially those who are receiving treatment for heroin and prescription drug abuse,” Portman said in a release earlier this month

This week the Senate began writing their own version of the bill. Next week, the Congressional Budget Office is expected to issue its analysis and cost estimates of the House bill. Previous estimates of the original version of the bill projected 24 million Americans would have lost their insurance coverage by 2026.

Have an issue for our Truth Squad to tackle? Email Joe Rosemeyer at joe.rosemeyer@wcpo.com or Lisa Bernard-Kuhn at lisa.bernard-kuhn@wcpo.com.

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