Medicaid caseload increases, rate increase on indefinite hold

"More than 700,000 low-income adults will continue to go without dental coverage, and hospitals and doctors caring for Ohio's poor will not get the Jan. 1 rate increase they were promised by the state." (Source: "Medicaid changes won't happen," Columbus Dispatch, Nov. 20, 2007.) The change, announced yesterday by Gov. Strickland's administration, results from a higher-than-expected caseload in Medicaid, which administration officials said meant Ohio could no longer afford the planned services and rate increase. The cost of the proposed changes was estimated to be $65 million a year.

According to the Ohio Department of Job and Family Services (ODJFS), Medicaid enrollment in the state declined in recent years, partly as a result of federal requirements for proof of citizenship. Total Medicaid caseload was at 1.744 million in September, lower than the 1.76 million at the same time last year. (Source: Gongwer News, Nov. 16, 2007.) However, Heather Burdette, chief financial officer for the Office of Ohio Health Plans, said last week "that the caseload figures reflected an increase of some 18,000 enrollees, or 1%, above estimates generated several months ago for the current biennium budget plan." Burdette told the Ohio General Assembly's Joint Legislative Committee on Medicaid Technology and Reform that her agency's analysts suspect the enrollment growth resulted from people becoming more familiar with the new federal citizen requirements.

With the restoration of dental benefits and the provider rate increase on indefinite hold, representatives of physician and dentist associations said they fear the "failure to make good on the promised increases will cause providers to drop out of Medicaid, further shredding the safety net for Ohio's poor." Tim Maglione, spokesman for the Ohio State Medical Association, said physicians haven't had an increase in Medicaid rates for seven years and that "it's becoming harder and harder for physicians to stay in the Medicaid program when the reimbursements don't keep pace with practice expense and inflation."