Report: State, federal Medicaid proposals would hurt rural Ohioans

Enrollment since Ohio expanded its Medicaid program is
nearly 2.5 times larger than the initial estimates
from 2013. (Adam Avitable/Flickr)

By Mary Kuhlman
Ohio News Connection

As the Medicaid program faces possible changes at both the state and federal level, a new report finds the changes would be especially difficult for Ohio's rural counties.

This week, Republicans in Congress are expected to vote on a repeal of the Affordable Care Act that includes cuts of $800 million to Medicaid.

And Ohio's proposed budget makes it harder for those who are unemployed to maintain their Medicaid coverage.

John Corlett, president and executive director of the Center for Community Solutions, says his group's research shows this combination would have a disproportionate impact on rural Ohioans.

"Policymakers have this sense that Medicaid is an urban program, and that's really not true," he points out. "Rural communities in Ohio have much less infrastructure to help them and so, Medicaid plays a much more important part in providing health care, to supporting employment, and making people healthier."

The report says rural counties have a higher percentage of their population enrolled in Medicaid than the state average, and many high enrollment areas also have higher unemployment rates.

And Corlett notes these areas also have higher per-capita spending on Medicaid, so cuts to the program would have an even greater impact on their local economies.

Ohio expanded Medicaid in 2014, but a proposal at the Statehouse would freeze new enrollment and prohibit anyone who falls off the rolls due to income changes from reapplying for coverage.

Corlett sees that measure as counterproductive.

"For example, if a plant or a large employer in a community closes, we want to make sure that people are able to access the Medicaid program so they can maintain their health care coverage," he states. "This proposal in the state budget would make that much more difficult for many people."

Some lawmakers say the freeze is needed because current Medicaid expansion enrollment is nearly two-and-a-half times larger than the initial estimate from 2013.