Ohio Medicaid submits Group 8 work‑requirement demonstration to CMS; expert warns budget risks in House Bill 96

Director Corcoran, director of the Ohio Department of Medicaid, said the agency submitted its Group 8 eligibility and “community engagement” demonstration to the Centers for Medicare & Medicaid Services in line with a House Bill 33 requirement and outlined the state’s estimates and implementation plans.

Corcoran told the Joint Medicaid Oversight Committee that, using current definitions and conservative assumptions, the department estimates roughly 800,000 Ohioans meet the new Group 8 eligibility criteria and that a substantial share — about 41 percent — are already working. He said about 45 percent of Group 8 enrollees receive behavioral health treatment services and roughly 15 percent receive substance use disorder treatment.

“The waiver was submitted in accordance with the timeline specified in House Bill 33,” Corcoran said, adding that the department presented maps and data to show geographic variation in need and likely assessment burden. He said the federal public comment period on the submission is open and that CMS’s comment window closes on April 7.

Why it matters: House Bill 33 directed the Department of Medicaid to submit the Group 8 demonstration, which establishes new eligibility limits tied to work, age and health conditions. If approved, the demonstration would change how some adults gain and retain coverage and require county and managed care organization involvement for eligibility assessments and care coordination.

What the department told the committee

- Eligibility profile and uncertainty: Corcoran emphasized the numbers are estimates because final regulatory definitions will be set by CMS. He said the department’s profile shows a slightly higher share of men than women in Group 8, about 9 percent aged 55 or older, and a group with higher-than‑average rates of chronic illness (he cited a roughly 12.6 percent share with severe chronic conditions or serious mental illness). He…