The Center for Community Solutions is committed to monitoring and researching the impact of waivers or other proposed changes to Medicaid eligibility or access. During this biennial Ohio budget process, we kept track of a variety of proposed changes that had the potential to affect this population.
After some deliberation, the Healthy Ohio proposal from the House budget process did not find its way into the Conference Committee report.
After some deliberation, the Healthy Ohio proposal from the House budget process did not find its way into the Conference Committee report. However, a broad House proposal regarding shared savings and quality did end up in the document which would require a waiver. [bctt tweet="#MedicaidWaivers were a hot topic during the #OHBudget process. Which one made it in the final version? Find out here" username="CommunitySols"]
Unlike the Healthy Ohio proposal, this provision, listed under the line-item MCDCD50 of the comparison document, would create a waiver under which Medicaid managed care organizations (MCOs) “may cover any service or product that would have a beneficial effect on enrollees’ health and is likely to reduce the costs… within three years.” On its face, this proposal sounds like policy that enables the state to finance non-medical expenses associated with the social determinants of health – things like food and transportation. While we have written about these social determinants extensively (like housing, food, education, and transportation) and believe that concept has merit, but such a waiver may have some unintended consequences.
The state’s current process of rebidding MCO contracts will offer plenty of opportunities for MCOs to better coordinate services around the social determinants of health
First, the state’s current process of rebidding MCO contracts will offer plenty of opportunities for MCOs to better coordinate services around the social determinants of health. Before any major new project is sought through a waiver, that contractual process should be finalized and the impacts of the current work requirement waiver should be better understood. What’s more, the language as written, combined with guidance from the Centers for Medicare and Medicaid Services, enables the state to pursue a path which would block grant the Medicaid program. If that were to be the ultimate result, the most likely impact would be significant cuts to coverage as we and others have shown.
