Health plans

New health plans for Ohio Medicaid won’t start until the end of the year

The planned launch date for Ohio’s revamped and reformed Medicaid managed care system will still be July — except this month, given a potential crisis where many can be kicked out of Medicaid, the state pushed back most of the reforms until the end of this year.

“It seems like this new incremental approach still allows them to move forward with everything, but in a manageable way…to maybe take smaller bites of the apple,” said Loren Anthes, who chairs the Center. for Medicaid Policy by Community Solutions. .

Medicaid, government-paid health insurance for more than 3 million low-income or disabled Ohioans, is typically the state’s largest expense, totaling billions of dollars. The “next generation” system is the result of an extensive process that began in 2019, looking for ways to overhaul the system after years of problems and lack of reform.

According to the Ohio Department of Medicaid, one of these reforms will still be operational in July. OhioRISE is a new coverage system to treat children with serious behavioral and mental problems so that parents do not have to give up custody.

But all other more complicated changes, like a sole manager of pharmaceutical benefits to prevent prescription drug “middlemen” from overcharging taxpayers, won’t happen until October at the earliest. The same goes for the two to three new health plan options coming into the system: AmeriHealth Caritas, Humana and Anthem Blue Cross and Blue Shield.

Why the delay?

The planned July launch date could coincide with the end of the federal government’s COVID-19 emergency declaration, which has prevented states from deporting those ineligible for Medicaid. When that ends, almost everyone will have to go through eligibility checks – a daunting task for an understaffed system that could also leave Ohioans wondering if they still have health insurance.

Staggering Medicaid reforms later in the year would prevent a doomsday scenario where eligibility checks and new reforms go wrong at the same time, said Anthes, the Medicaid policy expert.

“It is important that the reforms and improvements incorporated into the Next Generation program are not undermined by a rushed launch or potentially confusing communications,” the Medicaid Department said in a document sent to lawmakers.

Despite the later deadline, Medicaid participants can still choose to enroll in one of the new plan options now, department spokeswoman Lisa Lawless said. They will simply remain on their current health plan until the end of the year when the change occurs.

New system start dates were pushed back before, and some lawmakers have expressed concern about the implementation time. But the ministry insists they are in no rush.

“Doing this correctly is more important than sticking to an administration-imposed timeline,” he told lawmakers.

Titus Wu is a reporter for the USA TODAY Network Ohio Bureau, which serves the Columbus Dispatch, the Cincinnati Enquirer, the Akron Beacon Journal and 18 other affiliated news outlets in Ohio.