Ka­sich seeks more con­ser­va­tive model for Med­i­caid ex­pan­sion

Modern Healthcare - - REGIONAL NEWS - —Vir­gil Dick­son

Ohio Gov. John Ka­sich’s ad­min­is­tra­tion wants to tran­si­tion the state to a more con­ser­va­tive Med­i­caid ex­pan­sion pro­gram that would al­low it to drop adult ben­e­fi­cia­ries who don’t pay into a health sav­ings ac­count, re­gard­less of their in­come.

In his 2015 bud­get pro­posal, Ka­sich, who is run­ning for the Repub­li­can pres­i­den­tial nom­i­na­tion, sug­gested as­sess­ing pre­mi­ums for adults above 100% of poverty. GOP state law­mak­ers last sum­mer passed a bill to have the re­quire­ment ap­ply to all pro­gram ben­e­fi­cia­ries.

Pun­dits aren’t sure that will help Ka­sich win votes among those in his party who did not ap­prove of the gover­nor’s de­ci­sion to ex­pand Med­i­caid in 2013.

Last week, his ad­min­is­tra­tion posted a sum­mary of a waiver the state plans to sub­mit to the CMS for ap­proval.

Un­der the plan, mod­eled af­ter Healthy In­di­ana Plan 2.0, Med­i­caid ben­e­fi­cia­ries above and be­low the poverty level must con­trib­ute monthly to an HSA. The amount would be equal to 2% of their in­come, but could not ex­ceed $99 per year, or $8.25 per month.

Mem­bers who are more than 60 days be­hind on pay­ments would be dropped from the pro­gram and re­quired to pay back the amount prior to re-en­roll­ment.

The waiver isn’t likely to be ap­proved, since HHS has yet to OK a waiver that al­lows in­di­vid­u­als be­low the federal poverty level to lose cov­er­age for not pay­ing into an HSA.

The full waiver will be posted for pub­lic com­ment April 15, with the docket clos­ing May 13. A pub­lic hear­ing on the waiver will be held April 21 in Colum­bus, Ohio. The state is seek­ing a Jan. 1, 2018 im­ple­men­ta­tion date for what it’s call­ing the Healthy Ohio pro­gram.

On the cam­paign trail, Ka­sich has faced con­sid­er­able crit­i­cism for his 2013 de­ci­sion to by­pass the state Leg­is­la­ture to ex­pand Med­i­caid un­der the Af­ford­able Care Act while say­ing he would sup­port a re­peal of the law. His move led to 600,000 state res­i­dents gain­ing cov­er­age.

Ohio Gov. John Ka­sich

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