Maternal & Infant Health
Public testimony

June 8: Senate Sub Bill Recommendations

June 8, 2023
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June 8, 2023  

Dear Members of the Senate Finance Committee,  

We appreciate the time and attention you’ve given to the budget process. We recognize the volume of requests that have come your way in the last weeks and want to thank you for the opportunities created to discuss policy priorities across every sector. The Center for Community Solutions would like to address several areas of concern in the Senate’s current version of House Bill 33 and provide some additional context for why these issues are so vital to the wellbeing of Ohioans.

Healthy Aging Grants

We request support for Amendment SC2905 (attached) to restore funding for the Healthy Aging grants within the Department of Aging. These grants will be administered through local partners and can be used to help older Ohioans live safely in homes, which often only need minor modifications as folks age. Supports could include retrofitting the homes of older residents to address challenges with utilizing stairs, installing bathtub rails and providing other supports, like nutrition services and transportation. As the department points out, these grants can also help to delay entry into Medicaid, preserve their personal assets, and promote a healthy, independent, active lifestyle. In a state like Ohio, with an aging population, supporting these grants will go a long way in helping older Ohioans continue to live safely in their homes.

Women’s and children’s health

Access to doulas  

We are disappointed in the removal of the provision added by the House to create a certification process for doulas and provide Medicaid reimbursement for doula services. Ideally, we would like to see this happen through the budget process, as this would kickstart the development of rules and a payment mechanism through Medicaid and support for doulas has been separately passed in each chamber over the last two General Assemblies. This issue has bipartisan support across both chambers and we implore the restoration of this provision.  

Increasing access to doula services has been proven to improve maternal and infant health outcomes, especially for Black moms and babies. The involvement of doulas into the normal course of care before, during and after childbirth has proven to provide better birth outcomes for mothers and infants compared to those that are without. Doula assisted mothers are four times less likely to have a low-birth- weight baby (one of the leading drivers of infant mortality) and are two times less likely to experience a birth complication involving themselves or their baby and significantly more likely to initiate breastfeeding.  

Medicaid coverage for children and pregnant women  

We support the Governor’s proposal to increase Medicaid eligibility to 300% of the federal poverty level for children and pregnant women and ask for the restoration of coverage to these populations. This policy will go a long way in ensuring continuity of coverage and access to care, especially during the critical postpartum period where we’re seeing increased maternal mortality and morbidity. This will also build upon the work done in the last state budget, inserted into the budget by the Senate, that expanded coverage for pregnant women from 60 days to 12 months postpartum.  

Continuous Medicaid coverage for kids  

To further build upon these beneficial coverage expansions, the House included continuous coverage for kids on Medicaid up to their 4th birthday in the budget. We think it is vitally important that the Senate restore this provision. Continuous coverage means that once a child in this age range is enrolled in Medicaid, they would stay enrolled without an annual redetermination, until the age the continuous coverage ends.  

Our research1 shows that when parents lose Medicaid coverage, for whatever reason, there are significant rates of coverage loss for their kids, even though these children may still be eligible. This is because we cover kids up to a higher income range than adults. Other states have adopted or are exploring policies that would provide continuous coverage to young children and we know what a difference this will make for continuity of care and access for Ohio’s kids. It is our collective responsibility to keep Ohio’s children safe and healthy. It is critical that children have access to health coverage and restoring this policy in the Senate budget will make a big difference for keeping kids connected to health services.

Access to food and nutrition

We have serious concerns about the provisions added to the budget related to the Supplemental Nutrition Assistance Program (SNAP) and the barriers these changes would create to accessing food and nutrition for Ohio’s families. We find a few provisions particularly harmful.  

The requirement for individuals ages 16-59 to participate in Ohio’s employment and training program as a condition of eligibility for SNAP benefits would impose a massive expansion of Ohio’s failing mandatory SNAP employment & training (E&T) program, which currently only applies to 18-49 year olds considered able-bodied adults without dependents. This provision would be the most extreme of its kind in the country and risks taking SNAP away from approximately 385,000 needy Ohioans, including 170,000 children, as well as their parents and other caregivers who live with them.  

Ohio’s existing mandatory SNAP E&T program is under corrective action from the U.S. Department of Agriculture’s Food and Nutrition Service for “chronic and critical program access and program quality deficiencies” including for failing to properly screen for exemptions for individuals with disabilities. Furthermore, funding is so limited that counties are unable to offer quality training or job placement opportunities for the vast majority of adults subject to its requirements. We encourage the removal of this provision.  

The prohibition of ODJFS from seeking a waiver from the SNAP time limit that applies to able-bodied adults without dependents would hamstring current and future Governors to decide for Ohio what is best for the state based on economic conditions. While the effect of eliminating time limit waivers may be small in the short-term, banning future use is short-sighted and we encourage removal of this provision.  

The Senate-added provision that specifies that a household is not a categorically eligible household for purposes of receiving SNAP benefits if any members of the household receive or are authorized to receive a noncash, in-kind, or other similar benefit would reimpose an asset test. Research shows that the SNAP asset test is counter-productive to efforts to promote work, as it discourages families from saving to escape poverty. The federal SNAP asset test is extremely low ($2,250 for most families) and includes car valuations. At a time of high inflation of car prices, an old used car could easily get valued high enough to disqualify working families from SNAP. To support working families and encourage self-sufficiency, the Senate should remove this outdated policy.  

In conclusion, we thank the members of the committee for taking this information into consideration as it moves toward passage. We are ready to work with committee members on making these changes.  

Thank you,  

John Corlett Tara Britton President and Executive Director Director of Public Policy and Advocacy  

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