Who Gets Medicaid In Ohio?
Recently much has been said and written in the media about Medicaid and who receives Medicaid. There are a lot of misconceptions regarding Medicaid eligibility and who actually receives Medicaid. Much of this information was reported in Cleveland.com, the web site of the Cleveland Plain Dealer and it is information that is readily available to the public. I feel that it is very important to share this information so people can have a better understanding about a very important part of our health care system.
Medicaid goes back to 1965 when President Johnson signed the bill into law that created Medicare. Medicaid was established at the same time as a welfare program for those in poverty. Unlike Medicare, Medicaid is a joint federal / state program, so when one is eligible for Medicaid, that comes through the state of Ohio. Medicaid programs are different in each state and as a result Medicaid eligibility does not transfer from one state to another.
Prior to the expansion of Medicaid under the ACA or Obamacare in 2014; in order to be eligible for Medicaid one had to be either over age 65, totally and permanently disabled, legally blind or caring for dependent children under age 16 in the house in addition to having income and resources within the Medicaid eligibility limits. Prior to the 2014 Medicaid expansion, the upper income limit was roughly 70% of the federal poverty level or about $673 per month for a single adult today. The Medicaid expansion under the ACA increased that income limit to 138% of the federal poverty level or roughly $1350 per month for a single adult and eliminated the other requirements so anyone whose income and resources were under the limits would be eligible.
The expansion allowed single adults and childless couples under age 65 and not disabled to become eligible for Medicaid. It also allowed many working poor whose income was within Medicaid eligibility limits to become eligible as well.
So who gets Medicaid right now in Ohio? According to the Health Policy Institute of Ohio; 39% of those on Medicaid in Ohio are non disabled children and pregnant women, 22% are because of the expansion of Medicaid under the ACA, 15% are low income non disabled, non elderly parents, 12% are aged, disabled and blind, 9% are special circumstances and 3% are young adults transitioning such as foster children.
But when it comes to where the money is spent on Medicaid, the picture looks radically different. According to the Health Policy Institute of Ohio 48% of Medicaid expenditures are spent on the elderly, disabled and blind, 21% on the Medicaid expansion (where 95% of the cost this year is from the federal government), 13% is spent on the low income, non elderly, non disabled parents, 12% on non disabled children and pregnant women and 6% on those in special circumstances and young adults transitioning.
Much of that money spent in the elderly, disabled and blind are spent on long term care and especially nursing home care. In fact in Ohio, more than 60% of nursing home costs are made by Medicaid and that percentage is increasing rapidly.
In addition, Medicaid eligibility varies quite a bit county by county in Ohio as well. As expected the large urban counties like Cuyahoga concentrate a lot of the Medicaid beneficiaries in Ohio. According to the Ohio Department of Medicaid, Cuyahoga County has 23.9% of all adults ages 19 to 64 receiving Medicaid. The counties with the highest percentage of adults ages 19 to 64 receiving Medicaid are those rural counties in southern Ohio’s Appalachian region. Scioto County along the Ohio River has the highest percentage of adults on Medicaid at 30.4%. Not surprising, the Ohio counties with the lowest percentage of adults on Medicaid are those mostly suburban counties. Geauga County has the lowest percentage of adults on Medicaid with only 6.7% of adults receiving Medicaid.
But Medicaid eligibility is also fluid. People come on and off Medicaid as income changes. Young adults on Medicaid get jobs. Older Medicaid beneficiaries may become eligible for Medicare. Children grow up and come off Medicaid. Working age adults find jobs or make more money and become ineligible.
But the most important thing about Medicaid is that for those with limited income and assets, being eligible for Medicaid can be a life saver should a serious illness or injury strike. That person on Medicaid may be your neighbor, the waitress who serves you the coffee at your favorite restaurant, the person at the register at the local store or someone’s elderly mother in a nursing home.
Lee has been working with Medicare, Medicaid and private health insurance since he began working at the Erie County Welfare Department in January 1973 where a major part of his job was determining eligibility for Medicaid. He went into the private insurance business in 1977 with Prudential Insurance Company and within a short time had become one of the company’s top sales agents. In 1982, he was promoted into management where he managed two field offices and as many as thirteen sales agents. After leaving Prudential in 1986, Lee decided to become more focused on health insurance and employee benefits. He has advised many local employers on how to have a more cost effective employee benefit program as well as conducted employee benefit meetings and enrollments for many area employers. The companies Lee has worked with ranged from small “mom and pop” businesses to local operations of large national companies. Lee received his B.S. degree from Kent State University where he has been active in the local alumni association. He has completed seven of the ten courses toward the Certified Employee Benefit Specialist designation. He has taught courses in employee benefits and insurance at Cleveland State University and local community colleges. In addition, Lee is an experienced and accomplished public speaker. He has been a member of Toastmasters International where he achieved the designation of “Able Toastmaster – Silver” in 1994. He has also served as a club president, Area Governor and District Public Relations Officer in Toastmasters as well as winning local speech contests. Lee has also been a member of the Greater Cleveland Growth Association’s Speaker’s Bureau where he was designated as one of the “official spokespeople for the Rock and Roll Hall of Fame” prior to the hall’s opening in 1995. He has given talks and presentations before many audiences including civic organizations, AARP chapters and many other community groups. With the implementation of the Medicare Modernization Act (Medicare drug bill) in 2006, Lee has shifted his focus to Medicare and helping Medicare beneficiaries navigate the often confusing array of choices and plans available. As an independent representative, Lee is not bound to any one specific company or plan, but he can offer a plan that suits an individual person’s needs and budget. In addition, Lee is well versed in the requirements and availability of various programs for assistance with Medicare part D as well as Medicaid. While he cannot make one eligible, he can assist in the process and steer one to where they may be able to receive assistance.