Medicaid
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Medicaid is more than a line item in the budget

Brandy Davis
Fellow, Medicaid Policy
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When our CEO Emily Campbell asked me to provide opening remarks at the City Club forum she was moderating on May 16, Trigger Point: Protecting Medicaid Expansion & Healthcare Access in Ohio.

As the Medicaid Policy Fellow at The Center for Community Solutions, I know how important our work is in this moment. Our small staff works every day to help make connections between people and organizations working to improve community conditions and the quality of life of all Ohioans.

Here’s what I said.

One of the ways in which we can start to make those connections is by connecting amongst ourselves. So, every Monday we have a meeting and a check-in question. Our check-in question is a way for us to join in together and start thinking before the week really begins. This past Monday, our check in question was, “Which public benefit program would you choose to protect over the next 25 years?” Our research director did one of the things she does best, and she made a graph. And while responses ranged from the Supplemental Nutrition Assistance Program, commonly referred to as SNAP or food stamps to Child Tax Credits to Social Security, thirty percent of our staff chose Medicaid.

Which public benefit program would you choose to protect over the next 25 years?

I questioned why. I was not a part of the 30 percent. Surprisingly enough. Having worked in Community Health Centers where housing first models have been required for federal grants over the years. And then treatment first models were required as opposed to housing first models. And back and forth. I thought, “Obviously, we have to feed people before we treat people.” But at least thirty percent of my colleagues thought differently. When I asked why, though I received varying responses, the general sentiment was that “If you have health care then you are able to be productive in your job and with family.”

That stuck with me. Because since 2014, when Ohio took the bold step to expand Medicaid under the Affordable Care Act, over a million additional adults have gained coverage. That is over a million adults who can be productive in their jobs and with their families.

One area where those dollars really make a difference is behavioral health.

The steady stream of behavioral health funding is so very important for rural hospitals operating on much slimmer margins. Without Medicaid’s support, many of those smaller hospitals would face significant uncompensated-care costs, and some might even close their doors leaving entire communities with nowhere to turn in an emergency.

For older adults and people living with disabilities who want to stay in their own homes, the home and community-based services are lifesaving. Home-and-community based services that include things like personal care and home-modifications, so that people can age in place and live with dignity and avoid expensive nursing-home or long-term care stays, are vital to so many Ohioans.

The Ohio Department of Medicaid recently submitted a waiver that would require the expansion population to submit proof that they are adding work requirements that would require adults ages 19-54 to submit unnecessary paperwork.

Why would work requirements be problematic?

I recently mentioned this in a meeting and received a question. Why would work requirements be problematic? The answer is simpler than many would imagine. We know that people are already working. Work requirements only make us have to create more paperwork to prove that people are working. The work requirement waiver that the Ohio Department of Medicaid has recently submitted would require that people in the expansion population submit unnecessary paperwork about what we already know. They are working. Or caregiving. Or in a treatment program. Or in school.

And if Medicaid expansion ever goes away, we are looking at 770,000 Ohioans who have had health insurance coverage that has allowed for regular checkups, medications, and preventive care screenings and helped them to manage chronic health conditions and, as was stated by my colleagues in our Monday morning check-in—allowed them to remain productive in their jobs and with their families.  

Medicaid in Ohio is more than a line item in our budget. It is a commitment to our economy. It is a way to access health care for many. It is the difference between an emergency department visit you can afford and one you can forgo. It is an opportunity to keep our neighbors, our families, and our communities healthy and living their lives right where they are.

That’s why Community Solutions is proud to serve as a community partner for today’s forum.

Watch the May 16 City Club forum on-demand

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