- Associated Press - Monday, February 2, 2015

COLUMBUS, Ohio (AP) - Gov. John Kasich’s state budget plan would continue to fund an expansion of Medicaid as his administration seeks to charge a monthly premium to certain residents on the health care program, state officials said Monday.

The administration would need federal approval to charge the monthly fee to low-income individuals on the federal-state Medicaid program.

Kasich, a Republican, pitched the idea as helping to drive a sense of “personal responsibility” in the program and ensure public support at a time when he says welfare programs are under attack.

“It isn’t a lot of money what they’re being asked to put in there,” he said. “But it is my goal, through these programs, to restore legitimacy and strength to our social service network.”

Ohio Medicaid already has co-payments for certain medical services such as dental visits.

With the proposed premium, recipients above 100 percent of the federal poverty level would pay between $15 and $22 a month to access Medicaid coverage, officials said. The amount would be calculated in a similar way to those premiums paid by consumers purchasing private health plans through the federal insurance marketplace.

If approved, about 100,000 Medicaid recipients could be subject to the premiums next year, the administration estimated.

The administration said the premiums would make it easier for residents to transition off the Medicaid program to private coverage when they can. The provision also is expected to save the state $1.6 million in 2016 and $3.2 million in 2017.

Officials would look at the impact the costs could on people with hardships, including those considered medically frail.

“But then ultimately our requirement is that there is a premium, and if a premium is not paid then we will dis-enroll the person from the Medicaid program,” Ohio Medicaid Director John McCarthy said.

He said the state would offer a grace period to pay the premium and would work with individuals to get back on Medicaid.

Kasich extended eligibility in 2013 to cover thousands more Ohioans, as allowed under President Barack Obama’s health care law. Roughly 451,000 Ohioans have enrolled under the expansion, which boosted eligibility to those with incomes up to 138 percent of the federal poverty line, or about $16,200 for an individual.

The governor’s budget seeks funding to continue the expansion.

Obama’s law calls for Washington to pay the full cost of the Medicaid extension through 2016 and 95 percent in 2017, so Ohio will have to kick in $120 million during the new biennium to support the state’s share of expansion.

The Ohio House will begin hearings on the budget Tuesday.

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