State Report Shows Medicaid Expansion Resulted in Better Health Outcomes

House Bill 64 of the 131st General Assembly required the Ohio Department of Medicaid (ODM) to provide a report that evaluated the impact of Ohio’s 2014 Medicaid expansion. ODM released the report in December 2016—the Ohio Medicaid Group VIII Assessment—and it examines how the expansion has affected new enrollees in regard to access and utilization of health care, physical and mental health status, financial distress/hardship, and employment. This report is one of the nation’s most comprehensive assessments of a state’s Medicaid expansion. Click here to view the full report. 

Numerous methods were used to collect data for the report, including a detailed telephone survey of 7,508 Group VIII and pre-expansion enrollees, a biometric screening of 886 respondents who completed the telephone survey (including both groups of enrollees), and interviews with 10 Ohio Medicaid service providers and other key stakeholders.

In May 2016, when the survey was conducted, 702,000 people were enrolled in the expansion, also known as the Group VIII population. “Group VIII” refers to the section of the Social Security Act that sets requirements for Medicaid expansion eligibility, and allowed most Ohioans age 19 through 64 with incomes at or below 138% of the federal poverty level (FPL) to become eligible for Medicaid, according to the ODM. Prior to Jan. 1, 2014, Medicaid eligibility for adults was limited to those with certain qualifying characteristics, such as parenthood or disability, and the income limitation for most Medicaid eligibility groups was lower than 90% of the FPL.

According to the assessment, enrollees reported better health outcomes and access to care, and fewer emergency room visits. 

Medicaid expansion not only showed improved health outcomes, the report indicated, but increased the ability of enrollees to look for and obtain work by alleviating much of the burden of medical bills and debt.

Key findings of the assessment include the following:

  • 43.3% of participants reported fewer unmet health needs since enrolling, while only 8.3% saw an increase.
  • 47.7% said their overall health had improved since participating in Medicaid, compared to 3.5% who said it worsened.
  • 27% were diagnosed with at least one chronic health condition after joining Medicaid.
  • 44% reported better access to mental health services.
  • 74.8% of expansion participants were unemployed but looking for work, and said enrollment made it easier for them to seek employment, while 52.1% of those who were already employed said the program made it easier for them to keep working.
  • 58.6% of enrollees said it was easier for them to buy food, 48.1% said it was easier to pay their rent or mortgage, 43.6% said it was easier to pay off other debts, and while 55.8% had medical debt before enrollment, only 30.8% had debt at the time of the study.

The report reinforced the idea that expanding access to health care relieves the burden of high health costs on people who are struggling economically, he said. Rural areas of the state have been particularly boosted by the program’s expansion, and not just because a significant percentage of residents have more access to care.

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