Butler County health care leaders support Medicaid expansion

Medicaid Expansion Pros and Cons

For Expansion:

Against Expansion:

Sources: Pro, Ohio Assocition of Community Health Centers; con, The Buckeye Institute for Public Policy Solutions

As the debate over Medicaid expansion in Ohio rages, a consortium of Butler County health care leaders threw their support behind the proposal Tuesday, saying the expansion would be good for health care and the economy by aiding the working poor.

A provision in Gov. John Kasich’s proposed biennial budget calls for the extension of Medicaid to individuals up to age 65 and up to 138 percent of the Federal Poverty Level.

Detractors claim that the provision would “trade dubious short-term gains for long-term losses.” But those in attendance at a rally for Medicaid expansion held at Primary Health Solutions in Middletown maintained raising the level to 138 would bring a lot of additional people into the system.

“Many of them work and fall just above the current line,” said Marc Bellisario, CEO of Primary Health Solutions. “In the current system, if you work, you can’t get assistance for health care.”

According to a “fast facts” summary issued by the Ohio Council of Behavioral Health and Family Services providers, the expansion would allow more than 275,000 low-income parents and single adults statewide to have coverage for the treatment of physical and behavioral health conditions.

The expansion, the summary said, would free up $404 million in the state budget over the next two years, will ensure that $13 billion in federal taxes paid by Ohio citizens would come back to the state.

“This policy creates 30,000 jobs… in the health care sector (and) in the private marketplace as people gain access to treatment and can successfully return to work and participate in Ohio’s economy,” the summary said.

An estimated 16,679 people in Butler County would sign up for Medicaid under the proposed expansion and 4,208 would do so in Warren County, according to a recently released report by a partnership of the Health Policy Institute of Ohio, Ohio State University, the Urban Institute and Regional Economic Models, Inc. The expansion is also estimated to generate $499,722 in sales tax for Butler County and $168,089 for Warren County, according to the 12-page report.

Bellisario said that many people who work in jobs without adequate health care insurance will often postpone seeking medical attention for problems until they become serious.

“Then they end up in emergency rooms, and that costs us all,” he said.

Scott Rasmus, executive director of the Butler County Mental Health Board, said that his agency has been operating off a tax levy that it passed five years ago and serves 9,500 clients.

“We foresee that (Medicare expansion) would free a half-million dollars or more in the next couple of years that would allow us to see 3,000 to 4,000 new clients,” he said.

Rhonda Benson, executive director of the Butler County office of the National Alliance on Mental Illness, said that many of the agency’s clients live under the National Poverty Level.

“Our focus will be impacted by this change,” she said. “Our clients will be able to manage their symptoms and hold a job.”

NAMI’s volunteer coordinator Denyce Peyton, who also has an adult daughter with mental illness, spoke at the gathering to provide personal testimony about the ability of Medicaid to reduce the financial and emotional stress on the families such as her own.

“Recovery for (her daughter) means a more stable attitude and medications that create a better balance of symptoms,” she said. “This affects her own quality of life and the family. The role of Medicaid has been crucial because it gives her access to a team of caregivers and the appropriate prescriptions she needs.

Middletown Health Commissioner Jackie Phillips said that the expansion of Medicaid would be beneficial to the economic development of the region.

“We keep talking about bringing in jobs, jobs, jobs,” she said, “but we need healthy individuals to fill those jobs.

“We’re spending a lot of unnecessary money because we’re not spending it on preventive health care,” she said.

“When the economic meltdown occurred in 2006, there was a dramatic change in the number of people we serve,” said Kimball Stricklin, CEO of Butler Behavioral Health Services. “We had just passed a levy and then had to serve a new clientele. The group that gets overlooked the most is the working poor, who fall into that gap between not bad enough yet and too well-off.

The common assumption that people who have a job also have insurance is not valid, he said.

“We often accuse this government of kicking the problem down the road,” he said. “If we don’t pass Medicaid expansion, we’ll be doing just that.”

The expansion, which is part of Kasich’s biennial budget, has caused controversy in the Republican-controlled Ohio Legislature.

Nick Stallard, a legislative aid for Ohio Rep. Wes Rutherford (R-Hamilton), said that the representative’s office is “still looking into it.”

“It’s a pretty hot topic,” he said. “Everybody’s trying to figure out where to go with it.”

He said that Rutherford has received a lot of emails and other messages from his constituents, a lot of whom are against it and a lot of whom are just seeking more information.

“A lot of our constituents see it as an extension of Obamacare, which they are vehemently against,” Stallard said. “When we see the bill out of committee, then we can tell our constituents what it means.”

In house testimony last week, Chris Littleton of the political action group Ohio Rising said that while “Medicaid is supposed to be a temporary welfare program” it has “become a way of life for so many.”

“By putting more people into an environment with no incentive to improve, prosper and change, we are creating a dependent, not independent society of people,” he said. “Higher numbers of people less dependent on government in their day-to- day lives creates a healthy and vibrant society, not the other way around.

In a policy report “Expanding Medicaid: The Wrong Decision for Ohio,” the Columbus “think tank” Buckeye Institute for Public Policy Solutions concluded that expansion of Medicaid would create an unsustainable “broad-based welfare program that covers able-bodied adults with incomes.”

“The Obama administration already recommended an adjustment that would cost Ohio an additional $2 billion. Even slight changes to federal spending rates will have devastating long-term effects for Ohio,” the report said.

“The expansion fundamentally transforms Medicaid into a much larger government welfare program,” the report concluded. “This is contrary to conservative, limited government, and free-market principles.”