“There are multiple contingencies, so it all depends on what direction the state moves,” Palmer said.
Eric Poklar, spokesman for the Governor’s Office on Health Transformation, said Kasich hasn’t made a decision yet. As the state goes into its budget-planning process, he said, Kasich has to consider the cost of expanding the insurance program.
The Affordable Care Act, passed in 2010 and upheld earlier this summer by the U.S. Supreme Court, gives states the option to expand Medicaid coverage to include adults who earn up to 138 percent of the federal poverty. The expanded coverage starts in 2014, and the federal government will pick up the entire cost for covering newly eligible adults through 2016.
Poklar said that while the federal government will cover the cost for newly eligible adults, many adults who are already eligible for coverage under existing state guidelines are expected to sign up for coverage, which could cost the state an estimated $940 million in 2014 and 2015.
There is no deadline under the new federal law for states to opt into expanded Medicaid.
The November presidential election may prove to be the deadline for the expansion. Presumptive Republican candidate Mitt Romney has said he’ll repeal the health law if he wins.
The election “has a lot of actions tied to it,” Palmer said. “If a new president comes in, one action’s going to happen. If the current president stays, obviously, there’s other actions taking place. It’s the waiting game.”
While the organization supports expanding access to healthcare and expanding coverage, money is an issue: Medicaid currently reimburses 82 cents for every $1 hospitals spend caring for patients, according to OHA. Medicaid losses and charity care added up to $2 billion in uncompensated care provided by Ohio hospitals in 2010, the organization said.
OHA, which is based in Columbus, represents 167 hospitals and 16 health organizations around the state.