Medicaid Expansion Works: Evidence from Ohio

“If it wasn’t for Medicaid, I would not have been able to pay for surgery that was needed for a heart condition I was born with.”

“Having Medicaid has meant that I’m able to pay my rent and get the health care that I need to stay healthy so I can keep working.”

“Having Medicaid coverage has meant getting my mental health and my disability somewhat under control. It has changed my life. It is life changing and I am so thankful.”

These are just some of the responses of enrollees of Ohio’s Medicaid expansion when asked “What does Medicaid mean to you?” They were surveyed as part of a recent comprehensive evaluation of Medicaid expansion in Ohio, and the results prove once again why Kansas should expand KanCare, the state’s Medicaid program.

The analysis shows Medicaid expansion is one of the most positive and comprehensive programs a state can implement to address access to care, the health of enrollees, employment, and family financial stability.

And yet, the findings should not surprise us. They echo the findings of dozens of other studies conducted in expansion states over the years. In fact, the Ohio analysis notes the studies that have come before: “All studies have shown significant benefits accruing to people living in Medicaid expansion states compared to similar people living in non‐Medicaid expansion states, with no negative effects – in all instances the benefit generally gets stronger over time.”

Here’s what the researchers in Ohio found:

• Medicaid expansion reduces the rate of uninsurance.
  • Ohio’s uninsurance rate for adults fell by more than half following Medicaid expansion. Those below 138 percent of the federal poverty level, the income group eligible for expansion, were two-and-a-half times less likely to be uninsured after expansion than before.
• Medicaid expansion enhances access to care.
  • Use of primary care and the percentage of enrollees with a usual source of care has increased in Ohio since expansion. There has been a corresponding decline in use of the hospital emergency department, demonstrating a shift toward preventive and more cost-effective care.
• Medicaid expansion benefits the health of enrollees.
  • Diagnosis and treatment of chronic conditions has increased with Medicaid expansion. Enrollees report enhanced health and mental health status and increased use of tobacco cessation services. Expansion has also enhanced the use of addiction treatment services in Ohio – rates of enrollees with opioid disorders receiving treatment and mental health counseling have risen steadily.
• Medicaid expansion facilitates and enables employment.
  • Medicaid coverage enabled treatment for debilitating conditions, making it possible for enrollees to keep working or return to work. More than 83 percent reported that having Medicaid made it easier for them to work and 60 percent of those who were unemployed stated that having Medicaid made it easier to look for work. The ability to work also greatly enhanced enrollees’ mental health status.
• Medicaid expansion enhances family financial security.
  • Those covered by Medicaid were much less likely to have medical debt, reducing financial stress and enhancing financial stability.

The evidence in favor of Medicaid expansion is overwhelming. Few public policy programs produce so many positive results across so many dimensions. There is no longer any substantive controversy over whether expansion works.

In Ohio, Medicaid expansion was implemented and administered by John Kasich, a Republican governor. Both candidates to replace Kasich – Richard Cordray, the Democrat, and Mike DeWine, the Republican – have pledged to preserve expansion if elected. Expansion is no longer a political issue. It is a mainstream position of both political parties.

The jury is in. There’s no dispute – expansion works. It’s time for Kansas to join Ohio and 33 other states and expand KanCare.

The Ohio study can be found here: http://www.medicaid.ohio.gov/Portals/0/Resources/Reports/Annual/Group-VIII-Final-Report.pdf