Ohio: States Establish Frameworks for Health Reform

In July, an advisory group appointed by Governor Ted Strickland produced a comprehensive report that included recommendations for meeting two goals set by the governor—to reduce the number of uninsured Ohioans by half and to increase the number of small businesses able to offer coverage to their workers. This report was the work of the 12-member team who participated in the Coverage Institute hosted by the State Coverage Initiatives (SCI) program; a larger Healthcare Coverage Advisory Committee that included nearly 50 representatives from stakeholder groups aided in their work.

• Employer Sponsored Coverage:
  • Design a reinsurance program to reduce the cost of coverage by about 25 percent for eligible small businesses and individuals;
  • Provide premium assistance for low-wage workers;
  • Require employers to offer Section 125 premium-only plans (see p. 53); and
  • Extend coverage for dependents up to age 29.
• Covering Lower Income Ohioans:
  • Employ outreach strategies for those individuals currently eligible but not enrolled in public programs;
  • Increase Medicaid eligibility to 200 percent FPL for parents; and
  • Allow childless adults up to 100 percent FPL to buy into Medicaid managed care plans with state subsidies.
• Reforming the Ohio Insurance Market:
  • Require those who can afford insurance to purchase it; 
  • Guarantee issue in the non-group market;
  • Adopt increasingly progressive rating rules to reduce the variance in insurance premiums in the non-group market;
  • Provide sliding-scale subsidies to help low-income individuals purchase private coverage; and
  • Create an insurance connector to help implement coverage expansions.
• The report also includes recommendations to improve value in the health care system and to contain costs, including adoption of health information technology, transparency and reporting requirements, and strategies that focus on prevention, primary care, and chronic care management.
• While not specified, the Advisory Committee recommended that funding for health reforms come from current sources where possible and where this is not possible, from a broad base of funding sources. The funding mechanism adopted should reflect the principle of shared responsibility.

Ohio’s SCI team report is now in the hands of Governor Strickland and members of the Ohio General Assembly. Decisions about moving forward with the recommendations will be made as Ohio prepares for consideration of its next biennial budget, to be introduced in early 2009.^[i]