Voices from Ohio on Medicaid expansion

Experience mirrors that of all states that expanded coverage under ACA

OHIO IS ONE of 31 states that expanded Medicaid as permitted by the Affordable Care Act/Obamacare for nearly all low-income citizens. The state’s Republican governor, former presidential candidate John Kasich, has been among the most vocal proponents of the expansion on the Republican side and has taken a lot of grief for it from ACA opponents.

In early January, the state released an evaluation of the impact of the expansion, “Ohio Medicaid Group VIII Assessment: A Report to the Ohio General Assembly“. (Group VIII is the legal name for the ACA Medicaid expansion population.)

The report has a host of quotes from interviews with individuals who benefited from the expansion, and I include a selection of these quotes below, along with a section from the report’s overall summary. This is what Medicaid expansion has meant to real Americans:

“It gives me peace of mind knowing that I don’t have to pay for the medical insurance, and it saves me money being able to afford food and utilities and everyday things you need in life.”

“It’s been a blessing and I thank God that I have Medicaid because I no longer have large payments and I can get my Medicaid medicines.”

“More freedom. Less worries. I was an addict for 3 years before getting Medicaid. Because of Medicaid I’m not an addict.”

“I’m happy that I can make appointments without going to the emergency room.”

“It brought some comfort to know if I was to get sick I can go to a hospital and get treatment and not have to get emergency room care.”

“It has helped me a lot. When I didn’t have Medicaid I wouldn’t go to doctor or hospital. I would use the hospital emergency room as a clinic.”

“[Medicaid is] a life saver. It’s got my blood pressure back down to almost normal. I’m just grateful for the coverage because I wouldn’t get this care without it because I know it isn’t cheap.”

“I can go to the doctor for my bronchitis and asthma and can get care. I’m able to be healthier and be more functional at work and able not to miss work because I can get health care that I can afford.”

“It means that I am healthier, I have asthma and before I couldn’t afford my inhaler. It’s been a lifesaver.”

“It’s meant that I can treat my Type 2 diabetes correctly, have it under control, which allows me to feel better, and work, and all around my quality of life has improved.”

“[Medicaid has] been a godsend. I was diagnose[d] with diabetes and high blood pressure which I did not know I had, and I’m now on medication to take care of those two situation[s].”

“It has saved my life. I have severe mental issues and I have depression and bipolar insanity ADD (Attention Deficit Disorder) and I am on several medications and I would not be able to take care of me if I didn’t have Medicaid.”

“It’s helped my mental health and I feel better about myself because I can get the care I need.”

“It’s meant I’ve been able to get treated for depression, get prescriptions, go to the doctor and get annual checkups. And dental and vision as well, I couldn’t afford health care before.”

“Medicaid has meant a great deal. It has enabled me to see my psychiatrist and family doctor. I’m grateful I have Medicaid.”

“It has helped me get through the tough times I’m in, as far as getting help with alcohol addiction and mental health care.”

“It has meant me being able to afford food, and paying my rent, and me not worrying about paying for a doctor’s visit.”

“It has greatly helped me out financially and helped me put food on my table and survive.”

“It has given us the freedom to see doctors now to be treated for medical reasons. It also has opened up that now we have more money left for our other expenses like food and such.”

“I had a lot of health problems before but a lot had changed in my life. Now I am able to work more.”

“I am finally getting everything that was wrong with me fixed so that I can go back to work. It’s a great help.”

“Give me the ability to seek employment without worrying about my health.”

And this is from the report’s conclusions:

In summary, Medicaid expansion has been beneficial to Ohio Group VIII enrollees in terms of: (1) access to physical and mental health care; (2) health care utilization and reduced emergency department use; (3) detection of unknown or unaddressed prior health conditions (particularly chronic health conditions); (4) security of and opportunities for employment; (5) the lessening of family financial stress; (6) declines in medical debt-holding; and (7) an increase in the ability to pay other nonmedical bills (e.g., household utilities, food, transportation). These results are similar to studies in other states that have found Medicaid expansion to be associated with improved access to and utilization of needed medical care (California, Maine, Massachusetts), increases in general health statuses (Arizona, Maine, Massachusetts, Minnesota), and reduction in stress―including financial stress (Minnesota and Oregon), and more appropriate health care utilization (a review of all expansion states). Finally, despite the short time elapsed since Medicaid expansion, Group VIII enrollees reported modest physical and mental health status gains, and most reported an increase in household, employment, and health security. Overwhelmingly, new enrollees reported being grateful for their Medicaid expansion health care coverage and valued having access to Ohio’s health care system.

This week we learned that the so-called “Freedom Caucus” of Republicans in the US House are frustrated with the slow pace of ACA repeal, and are now demanding immediate repeal of the ACA’s Medicaid expansion, among other cuts. Happy Valentine’s Day!

Meet the Author

John E McDonough teaches at the Harvard TH Chan School of Public Health and blogs at healthstew.com.