Here in the Valley, more than a third of the population gets health insurance through Medicaid.

The Medicaid rolls have grown in Ohio by more than 700,000 people since the beginning of the pandemic, with approximately 3.37 million Ohioans receiving benefits, and more than 185,000 individuals in the Valley receiving Medicaid.

There are nearly 87 million people in the US that are currently receiving health insurance through Medicaid.

The government will be looking to remove people from the program who may no longer qualify once a COVID-related Public Health Emergency extension expires. Now that a key deadline has passed today for notifying Medicaid recipients, that likely means there will be an extension for all those receiving health coverage through the program and more time to make sure your crucial information is updated to continue receiving coverage going forward, beating the processing crunch. 

With COVID numbers having declined this year, the Public Health Emergency and the Families First Coronavirus Response Act, which has prohibited states from removing people from Medicaid, will eventually be coming to an end, but the deadline for the Federal Government to announce an end to the PHE order is 60 days prior to the deadline. The current deadline was set for July 15, but no announcement today likely means the new deadline will be Oct. 13, and  60-days prior would now be August 14.

The Biden Administration has extended the COVID-19 PHE now ten times since it was first implemented in January of 2020.

All Ohioans that receive Medicaid will have to go through some level of redetermination through their local county Jobs and Families Services in order to maintain their coverage and an estimated 440,000 Ohioans will eventually be dropped from the rolls. Medicaid eligibility requirements will return to what they were pre-pandemic.

VALLEY MEDICAID NUMBERS

According to Ohio Medicaid Dashboard, Mahoning County has 86,998 Medicaid recipients (up 5.4 percent in comparison to March of 2021 numbers) and in March, 37.88 percent of the county was receiving assistance. Trumbull County has 66,869 enrolled (up 5.25 percent since last March), with 33.67 percent of residents receiving Medicaid benefits. Columbiana County saw a slightly larger uptick in recipients in the last year, with 31,402 receiving Medicaid, up 6 percent from last March.

As a whole, Ohio has 28.6 percent of the population receiving Medicaid, and 185,269 people total as of March 2022 in the Valley. Prior to the pandemic, Medicaid enrollment had been declining in the state since 2017.

However, with the arrival of COVID-19, from March 2020 through March 2022, Ohio Medicaid increased from 2.79 million to 3.37 million enrollees, up 20.5 percent, according to the Health Policy Institute of Ohio.

While the U.S. Department of Health and Human Services is giving states 12 months after the expiration of the Coronavirus Response Act, late last year Ohio legislature passed a bill stating the process must be completed in the state within 90 days from the end of the health emergency.

JOBS AND FAMILY SERVICES

Joel Potts, Executive Director for Ohio Jobs and Family Services Directors’ Association, which communicates on key issues about social services to Ohio’s legislature, said the most important Medicaid clients can do is to make sure that recipients have updated their contact information, current address, phone numbers so they can be reached if needed.

Anyone receiving Medicaid in the state needs to redetermine eligibility by calling 844-640-6446, or by visiting the state’s self-service portal at benefits.ohio.gov, or call or visit your county Department of Job and Family Services. If you know you may not qualify and will need to look for insurance in the near future, you can visit the website getcoveredohio.org/medicaid/ to view other Medicaid plans through the Health Insurance Marketplace or by calling 833-628-4467.

Potts indicated that mailings will go out to Medicaid recipients telling them exactly how to reapply for coverage, and if the information doesn’t reach you because of old information, it may cause you to lose coverage.

“We don’t want people to panic,” Potts said, stating that the Ohio Department of Medicaid is currently working with the counties' JFS departments to make sure each county has a process in place to handle all the requests.

Potts said it will take Ohio's counties a full year to redetermine all individuals receiving SNAP and hopes that OJFSDA can align SNAP and Medicaid cases.  "We will be looking closely for federal guidance on how we may proceed, " Potts said.

Potts said that while this is a lot of pressure being put on the JFS Service at the county level, Mahoning County Jobs and Family Service Director Audrey Morales said her department is ready and doing overtime to get through the caseload.

Morales said her department will be helping with questions and assisting with income verification and qualification needs.

Potts said it is the largest task ever taken on in the history of Jobs and Family Services, but the extension will allow the department more time if people take advantage and update their information ahead of the eventual end of the PHE order.

CONCERNS

Loren Anthes, who offers Medicaid policy oversight for The Center for Community Solutions, a nonpartisan, nonprofit think tank that focuses on health and human service issues primarily in Northeast Ohio, is concerned by Ohio’s decision to remove people in such a short time frame.

Anthes said the majority of individuals covered by the Medicaid program are comprised of children, as half of all births in the state of Ohio are financed by the Medicaid program, but Medicaid is the predominant payer for older adults.

“Lot of folks tend to think that Medicare is the way that most people receive a lot of their long term care services. But the reality is that Medicaid pays for most of the services and long-term care. And it’s also the primary source of coverage for disabled individuals as well, whether they be children or adults. So it’s a pretty significant program,” Anthes said.

“And we’re concerned because of some of the provisions that were included in that in the budget that also tied in millions of dollars of incentives to identify people who were who are going to be ineligible, and those incentives increase with the sicker you are,” Anthes added.

Anthes noted that if anyone has a friend or a family member who has been in a nursing home or in a hospital and relies on Medicaid, to make sure that those people’s contact information gets updated with the state as well.

OHIO REDUCING THE ROLLS

According to NBC News, Ohio appropriated $35 million to a Boston-based vendor called Public Consulting Group in which the state will pay 10 to 20 percent of its savings to the company, according to the November newsletter published by the Ohio General Assembly Joint Medicaid Oversight Committee, the NBC report states.

DETERMINING WHO STAYS, WHO GOES

The company's website states PCG will use third-party verification data, combined with policy-specific analytics, to quantify the level of ineligibility risk each of their Medicaid members represents. This risk assignment will allow these states to effectively prioritize and sequence Medicaid redeterminations based on the likelihood each member is ineligible while supporting a more efficient and accurate redetermination of eligibility. By doing so, each of these states can save hundreds of millions of dollars in unnecessary capitation payments that would have otherwise been made on behalf of ineligible members during the months between the end of the PHE and each member’s “scheduled” eligibility redetermination.

21 News reached out to Public Consulting Group to discuss how Ohio’s 90-day review would work but did not hear back from the Boston-based company.

OTHER OPTIONS FOR INSURANCE

Robert Denhard from the Ohio Department of Insurance Communications said there are several other health insurance options for Ohioans, including the Children’s Health Insurance Program, an ACA plan (including those with subsidies), employer-provided coverage, and Medicare. Denhard said that Ohioans should be mindful of enrollment time frames to ensure seamless health insurance coverage.

Ohioans can contact the Ohio Department of Insurance at 800-686-1526 with health insurance questions and our Ohio Senior Health Insurance Information Program at 800-686-1578 with Medicare eligibility questions.

You may also apply for benefits through the Affordable Care Act and look for insurance options there as well.