- Associated Press - Sunday, July 19, 2015

COLUMBUS, Ohio (AP) - Ohio is among a dozen states where enrollment has exceeded projections in the expansion of Medicaid under President Barack Obama’s health care law.

That’s raising concerns about costs straining state budgets. At least seven states have increased their cost estimates for 2017, according to an Associated Press analysis.

As states prepare to pay their share for the newly eligible population in 2017, here’s a by-the-numbers look at the program and its impact on state spending in Ohio:

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MEDICAID ENROLLMENT

- 365,616: People initially projected to enroll by June 2015 under Ohio’s Medicaid expansion.

- 537,010: Ohioans enrolled in Medicaid expansion, as of May.

- 446,795: Initial projection for enrollment under the expansion by fiscal 2020.

- Unavailable: Updated estimate for Medicaid expansion enrollees for 2020.

- 2.9 million: Ohioans on Medicaid, as of May.

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STATE IMPACT OF EXPANSION

- $55.5 million: Projected amount (before taxes) of state’s share of Medicaid expansion in fiscal year 2017.

- About $130 million: Expected amount of state’s share in fiscal year 2017.

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STATE SPENDING

- Nearly $7 billion, or about 20 percent: Portion of the same fund (state dollars only) spent on Medicaid in the 2010-11 budget.

- $11.9 billion, or 25.9 percent: Portion of Ohio’s general revenue fund (state dollars only) to be spent on Medicaid in the current two-year budget.

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ACCOUNTING FOR THE DIFFERENCES

The state’s share to cover those in the expanded Medicaid program in 2017 is more than twice what was projected, with officials now expecting to pay $130 million.

But the Kasich administration contends the cost is more than offset by revenue generated from the Medicaid expansion population through an insurance tax and the state sales tax. It estimates that Ohio will see $301 million in tax revenue from the group in fiscal year 2017.

The administration also is quick to point out that Ohio hasn’t been as affected by the so-called woodwork effect, when people who were already eligible for the program become aware of it and enroll. Such enrollees would have cost the state more money.

“You can’t take one without the other,” said Ohio Medicaid spokesman Sam Rossi said in an interview.

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PROPOSED CHANGES TO EXPANSION

The state budget that passed in June directs Gov. John Kasich’s administration to seek a waiver of federal Medicaid rules so that Ohio can require certain adults on the program to pay into a health savings account regardless of their income. Beneficiaries, except pregnant women, could be cut from the program if they don’t annually contribute 2 percent of their family income or $99, whichever is less. More details can be found here: https://1.usa.gov/1emexkF.

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Sources: Ohio Department of Medicaid; Ohio budget documents; AP research.


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