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Ohio health insurance

Ohio lawmakers split on ACA support, but uninsured numbers drop

  • By
  • contributor
  • August 20, 2014

A wide range of issues play a role in the overall health of a state’s residents. If you live in Ohio, there are numerous factors that could impact your own health outcomes and that might be of interest to you in terms of the state’s approach to healthcare and healthcare reform. Here’s a summary:

Ohio health ratings

The Commonwealth Fund’s 2014 Scorecard on State Health System Performance rated Ohio 31st out of the 50 states and District of Columbia – the same ranking they gave the state in 2009. Ohio’s Scorecard includes details on how the ratings are calculated.

But the state didn’t fare as well in the 2013 edition of America’s Health Rankings, which placed Ohio 40th in the nation. Ohio’s rating is helped by the fact that the state had a lower-than-average uninsured rate (13.9 percent in 2013), a high rate of high school graduation, and easily accessible primary care. But more than one in four adults in Ohio are physically inactive, and the state has a high incidence of diabetes. They also grapple with air pollution and a high rate of preventable hospitalizations.

Trust for America’s health has also compiled data on the prevalence of specific illnesses and health indicators in Ohio. The details are available in the 2014 listing of Key Health Data About Ohio.

But even within the state, there are differences in health factors and outcomes from one county to another. In general, the northwest part of Ohio fares better in most of these areas than the southeast. You can see Ohio health data on a county level with this interactive map created by the Robert Wood Johnson Foundation.

Ohio and the Affordable Care Act

In 2010, Ohio’s U.S. Senators were split on healthcare reform. Sherrod Brown, a Democrat, voted yes on the ACA, while Republican George Voinovich voted no. In the U.S. House, ten Ohio Democrats voted yes, while eight Republicans voted no. Brown is still in the Senate, but Voinovich has since been replaced by Rob Portman, a vocal opponent of the ACA. In the House, Ohio’s delegates now include 12 Republicans and just four Democrats.

Ohio’s state legislature has a strong Republican majority, and Republican Governor John Kasich is not a fan of the ACA in general. (He doesn’t see it as being effective in reducing healthcare costs and says it’s “messing up the economy.”) So it’s no surprise that Ohio opted for a federally-facilitated exchange rather than running its own exchange.

But Kasich broke ranks with most of his fellow Republican governors (and with his state’s legislature) in opting to expand Medicaid in Ohio. His reasoning is that it’s immoral to not do so, and he’s vehemently challenged Republicans on this issue. Ohio enrolled nearly 157,000 people in Medicaid as of mid-April, far more than most states with Republican governors.

How did the ACA help Ohio Residents?

In 2013, about 13.9 percent of Ohio residents were uninsured. By mid-2014, six months after the bulk of the ACA was implemented, that number had fallen to 11.5 percent. The Ohio exchange enrolled nearly equal numbers of people in private plans and in Medicaid during the 2014 open enrollment period, so exchange subsidies and Medicaid expansion both played a key role in the reduction of the number of people without health insurance.

Ohio enrollment in QHPs

The exchange in Ohio has 11 carriers participating in 2014, although not all of them are available in all counties. Most of the metropolitan areas of Ohio have at least four carriers available in the exchange, and 20 counties have an exchange selection that includes five or more carriers.

One of the carriers in the Ohio exchange is Coordinated Health Mutual, a Consumer Oriented and Operated Plan (CO-OP) created under the ACA with a federal grant of $129 million. The federal government awarded $2 billion in grants to 22 CO-OPs, and Ohio was one of the states that chose to participate in the program. Coverage is available statewide from Coordinated Health Mutual.

By mid-April when the 2014 open enrollment period ended, 154,668 people had finalized their private plan enrollments through the exchange. In late 2013, the Kaiser Family Foundation estimated the potential exchange market in Ohio to be 812,000 residents, and that 544,000 of them would probably be eligible for premium subsidies.

Hundreds of thousands of Ohio residents are still without coverage, but the 2015 open enrollment period (November 15, 2014 through February 15, 2015) will likely result in a significant decrease in the uninsured population in Ohio.

Ohio Medicaid/CHIP enrollment

Ohio’s acceptance of federal funding to expand Medicaid eligibility to 138 percent of poverty has played a significant role in the state’s success with Obamacare. (The ACA called for Medicaid expansion in all states, but the Supreme Court ruled in 2012 that states could opt out, and 22 states have not yet moved forward with any type of Medicaid expansion.)

In early 2014, the Kaiser Family Foundation estimated that about half of the uninsured population in Ohio would be eligible for expanded Medicaid or CHIP, in large part because of the more generous eligibility guidelines under the ACA. As of mid-April, 156,899 people had enrolled in Medicaid through the Ohio exchange. Enrollment in Medicaid is year-round, so that number continues to increase, making an ever-growing dent in the state’s uninsured rate.

State-based health reform legislation

Here’s a summary of recent Ohio bills related to healthcare reform: