State lawmakers have a responsibility to reform Medicaid
Feb 13, 2018This opinion piece appeared in The Hill, you can read the full piece here.
Michigan and Ohio may be bitter rivals on the football field, but these two neighboring states share a common problem. The GOP governor of each state — Rick Snyder and John Kasich, respectively — supported a state expansion of Medicaid under the Affordable Care Act. Now, Michigan and Ohio face costs far exceeding original projections, with the federal match rate declining and thousands of able-bodied working-age adults crowding out benefits to the most vulnerable. The two states are not alone in this predicament, as many other states expanded Medicaid and are now experiencing greater than expected enrollment and costs.
In Ohio, more than one-quarter of the state’s population is now enrolled in Medicaid, and state costs are more than twice as high as originally promised. Over the last year, the state’s Medicaid spending increased by 17 percent, which is why Ohio tried to reform its Medicaid program in 2016 through a waiver ultimately rejected by the Obama administration.
Michigan lawmakers are also bracing for renewed debate over the future of their Medicaid expansion, thanks to statutory trigger language requiring the state legislature to reauthorize expansion when state costs exceed savings. Though expansion was originally projected to add 450,000 to ultimately 475,000 able-bodied adults to the Medicaid rolls, that number was eclipsed within the first year of enrollment and has now exceeded 620,000.
