Whether or not to expand Medicaid coverage is the hot topic in developing state governments' next budget.
Yet the pushing and shoving from both sides is getting in the way of good policy-making in Columbus. And this is a call to move beyond that.
On one side is the massive and growing health care industry calling for an injection of billions of new federal dollars associated with rolling out the so-called "Affordable Care Act," passed by a previous Congress, a portion of which was banished by voters in the next election. This industry has recruited quite a coalition of supporters, including much of the mass media, some key business organizations and activist charitable groups.
On the other side we find noisy bands of citizens who are fed up with politics as usual and the ever-expanding reach of federal programs, paid for by borrowing future resources from our children and grandchildren. At times their frustration and anger makes their efforts appear self-interested and prevents them from working on real health care solutions.
But for those who want to truly help strengthen Ohio, it's time to dial down the emotional, sometimes mean-spirited debate and get to work on solutions that account for legitimate concerns on both sides.
Even more importantly, the focus must shift to our fellow Ohioans who need help because their circumstances are unhealthy. Who, how and when should we engage with them in ways that are actually helpful?
And so the conversation moves from whether to expand a government insurance program that pays providers of health care services to a more comprehensive call for all hands on deck to help more of our citizens overcome their difficult situations.
This kind of thinking was behind the unanimous vote by members of the Ohio House on a budget amendment that grew out of bi-partisan discussions between the members. The vote came during floor debate as the House was preparing to pass its version of the two-year budget due by the end of June.
This amendment, now a part of the budget version before the Ohio Senate and a work in progress, sets forth a number of objectives, including:
- Finding: identify individuals and families who are chronically under-resourced with greatest potential to obtain income and resources to move up and out of poverty.
- Lifting: employ strategies that enable these individuals and families to achieve and maintain financial independence through such things as workforce readiness, education and wellness programs.
- Graduating: through these initiatives, seek to graduate individuals and families either from Medicaid or from lacking health care coverage into private health care coverage.
- Reforming: work with the Governor's Office of Health Transformation and the Medicaid Director to build on major Ohio Medicaid reforms enacted by the legislature and signed by Governor Kasich in 2011, with additional strategies that result in more individuals being graduated up and off Medicaid than are being enrolled. Some of these additional strategies may require federal approval of plan changes and demonstration waivers.
- Succeeding: self-imposed goals for developing and enacting legislation yet this year.
A healthier Ohio is not a one-year project. But it is right to ask, "What can we do on this yet this year, and who is willing to help?"