Medicare finds savings in using house calls
Plain Dealer file photo from 2011.
(Lisa DeJong/The Plain Dealer)
CLEVELAND, Ohio - A new state budget proposal presented in the Ohio House of Representatives would limit the number of people eligible for Medicaid through the expansion.
The proposed budget would only cover under the expansion those who are 55 or older or medically fragile, employed, enrolled in a workforce training program or a recovery program.
But Tracy Carter, MetroHealth System's senior director of state and federal government relations, says such changes are problematic. The proposal would eliminate coverage for those looking for a job and those who need addiction treatment but can't access in-demand recovery services.
"It excludes those actively seeking a job through no fault of their own," Carter said.
MetroHealth, which is considered the county's safety net hospital, provides care for anyone - whether or not they have insurance coverage. The hospital system treats nearly 30,000 people through the Medicaid expansion, and 75 percent of its services are dedicated to patients with Medicaid or Medicare.
Since the state expanded Medicaid in 2014, 702,000 Ohioans have gained medical coverage.
"Most of these are able-bodied males without children," Akram Boutros, MetroHealth's president and chief executive officer, said during a hospital board meeting Wednesday.
"They're doing their part in society, not looking for a handout," Carter said. "We want to make sure this population is protected."
Losing access to healthcare coverage tends to make people delay preventive care, which can lead to more severe health conditions, Carter said.
"Our whole advocacy has been around making sure every Ohio resident has access, that they can stay well," Carter said.
Before changes to Ohio's Medicaid expansion are made, the budget first will have to pass the Ohio House and Senate and be approved by June 30. Then, the state will have to seek a federal waiver to amend the expansion.
Julie DiRossi-King, chief operating officer of the Ohio Association of Community Health Centers (OACHC), testified Thursday before the House Finance Committee against restricting Medicaid expansion eligibility.
OACHC represents the state's community health centers, which serve medically-underserved populations - with or without insurance - throughout Ohio.
"People without insurance, who don't have access to primary and preventative care, get more sick, do not treat their chronic diseases and end up costing the entire system far more than if they were covered and managed through Medicaid and sought appropriate care at the right time and in the appropriate cost-effective primary care setting," DiRossi-King said.
And even with the Medicaid expansion, a slice of the population still doesn't have insurance, Boutros said.
"Despite everything that has been done, there's some 9 percent of the population that remains uninsured, and MetroHealth takes care of these people," Boutros said.
But taking care of the uninsured is expensive.
"The business side of us is thinking about how do we make sure this person's care is covered in some way," Carter said. "We're a healthcare system but we're also a business."