Blackshear urges DeWine to reconsider Medicaid enrollment change for kids

The COVID pandemic allowed Ohioans to remain on Medicaid without eligibility re-checks; since that ended a year ago, 700,000 people of all ages have been disenrolled

A local state representative is calling on Gov. Mike DeWine to soften the Medicaid redetermination process’ impact on children’s coverage, while the governor’s office says this is part of the state returning to normal operations after the pandemic.

State Rep. Willis E. Blackshear Jr. (D-Dayton) sent a letter to DeWine asking for a pause on the Medicaid redetermination process for children as the state nears the end of its 12-month unwinding period of the health insurance program for low-income Ohioans.

The COVID-19 public health emergency included a provision that allowed nearly all Medicaid members to stay enrolled in their coverage plans regardless of changes in eligibility or status. That emergency ended in March 2023, requiring eligible Ohioans to go back to reenrolling for Medicaid.

“If we are serious about supporting families and children in this state, then we must do everything we can to ensure that they have adequate access to health care,” Blackshear said. “The recent reports about the number of Ohio children who have had their health coverage taken away is startling, and we owe it to them to quickly address this issue.”

Normal Medicaid operations include an annual reenrollment process to reconfirm eligibility, said Dan Tierney, press secretary at the governor’s office.

“Ohio has been commended by the federal government for doing this right and doing this efficiently,” Tierney said.

The state has to balance coverage of those who are eligible for Medicaid and the cost-effectiveness of the program, Tierney said. A state auditor’s report last month showed more than 124,000 people who were enrolled in Ohio Medicaid were simultaneously enrolled in Medicaid programs in other states for at least three months at a time from 2019 through 2022, according to Auditor of State Keith Faber.

The auditor’s office estimated the potential financial impact to Ohio of multi-state enrollees was more than $200 million, but Ohio Medicaid disputed that figure, saying it did not take certain factors, like the complicated process of capitation, into account.

Blackshear has called on the governor’s office to pause the disenrollment of children from Medicaid coverage, saying the state needs to be able to answer questions such as, “Of those disenrolled, how many have alternative methods of receiving coverage?” and “Of those disenrolled, how many still qualify for benefits?”

“We must develop and quickly implement a plan to ensure that our most vulnerable receive the medical coverage and benefits that they need. We cannot simply accept the fact that many of those facing disenrollment might not have alternative ways of seeking coverage,” Blackshear said in his letter to DeWine.

Ohio Medicaid’s unwinding reports say those who have been disenrolled due to ineligibility have been referred to the federal health insurance marketplace.

The state has done “significant outreach,” Tierney said, to remind Medicaid members of the need to reenroll starting up again since the pandemic started.

“I think we’ve taken a judicious approach,” Tierney said.

Since April 2023 when there were approximately 3.58 million Ohio Medicaid members, coverage has decreased by more than 400,000 people, down to about 3.16 million members as of March 2024, according to a state dashboard tracking enrollment.

For people who are under the age of 18, Ohio Medicaid coverage has decreased from approximately 1.31 million in April 2023 to 1.19 million in March 2024, a reduction of nearly 120,000 minors.

While that dashboard only tracks enrollment figures and can include new Medicaid enrollees, a Dayton Daily News analysis from earlier this year showed more than 600,000 Ohioans had been disenrolled from Medicaid as a result of the redetermination process in 2023.

For 448,433 cases ― which was more than 73% of the people who were disenrolled ― the beneficiaries were disenrolled due to a procedural reason, such as failure to respond, rather than being deemed ineligible, according to an analysis of Ohio Medicaid’s unwinding reports.

For 161,074 Ohioans, the state deemed them ineligible for Medicaid or CHIP benefits, referring them to the Marketplace instead. Nearly 1.9 million Ohioans have had their coverage renewed under Medicaid or Children’s Health Insurance Program (CHIP).

Adding in figures from unwinding reports from January through March of this year, another 50,603 people were disenrolled due to ineligibility and 111,861 were disenrolled due to a procedural issue over those three months.

Since April 2023, there have been 771,971 people disenrolled, according to Ohio Medicaid unwinding reports. The unwinding reports do not include the ages of those disenrolled.

Medicaid is one of the largest programs the state spends money on, Tierney said. For state fiscal year 2023, Ohio spent approximately $36.1 billion, including both state and federal funds, on the Medicaid program as a whole.

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