Medicaid remains the perennial Pac-Man of the state budget. Ohio continues to pick up additional financial burdens that will gobble up an increasing amount of state resources and crowd out other essential investments and priorities such as education and infrastructure.

Several cost-saving and personal responsibility provisions are positive. However, far more must be done to control costs.

With mystery swirling around Ohio’s long-term Medicaid budget due to anticipated changes coming from Washington, it is time for Ohio policymakers to craft comprehensive and innovative proposals, such as a state innovation waiver also known as a “1332” waiver. The Buckeye Institute is pleased to have produced the comprehensive research and guidebook showing how states can utilize these waivers and circumvent the most damaging aspects of Obamacare. This 1332 waiver would allow the state to begin creating a fully flexible Ohio model including implementing work requirements and even stronger personal responsibility from those in the Medicaid expansion population who are able to work.

Unfortunately, the plan to make up for the now-disallowed Medicaid Managed Care Organization (MCO) sales tax is significantly flawed. The plan is little more than a slight variation of the same shell game as the MCO sales tax. Further, subsequent presidential administrations could disallow it, which would create another large hole in the state budget.