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Advocates and disability groups urge removal or revision of expansion ‘trigger’ and oppose work requirement
Summary
Advocates and disability groups pressed the House Medicaid Committee to revise or remove a budget provision that would automatically end Medicaid expansion if the federal match falls below 90% and to oppose work requirements for the expansion population.
Advocates, disability-rights representatives and policy researchers urged the House Medicaid Committee to reconsider two parts of the governor's proposed budget that affect the Medicaid expansion population (group 8): (1) a trigger provision that would suspend expansion if the federal medical assistance percentage (FMAP) for expansion falls below the current 90% match, and (2) a waiver request to add community-engagement/work requirements for group 8.
Charlotte Rudolph of the Universal Healthcare Action Network of Ohio (written testimony), Catherine Poe of Policy Matters Ohio and Sarah Hudacek of Advocates for Ohio's Future testified that ending expansion coverage suddenly would cut roughly 770,000 Ohioans off Medicaid and leave many without affordable alternatives. Policy Matters noted the state faces a large potential bill if the FMAP drops: the department estimated roughly $390 million per 5% FMAP drop (annualized) and about $195 million for a six-month window, figures cited by witnesses in committee discussion.
Disability advocate Jennifer Kucera, leader of the Ohio Olmstead Task Force, described how people with disabilities and their caregivers would suffer from sudden coverage loss and warned that caregivers themselves may lose Medicaid and leave the workforce, further reducing home-care capacity.
On work requirements, witnesses said the administrative burden and evidence from other states show poor results. Advocates cited Georgia’s experience and national analyses that find work requirements raise costs and reduce enrollment without durable employment gains.
Why it matters: The trigger and waiver could cause abrupt coverage changes for a large group of enrollees, with downstream effects on hospitals, primary care providers and families. Committee members asked whether the language could be modified to provide phased or time-limited transitions instead of immediate cutoff.
What advocates asked: Amend the trigger to include an off-ramp or a notice period and avoid automatic suspension; drop or narrow any work requirement waiver; and if any federal match loss occurs, provide a plan that phases changes and preserves continuity of care where clinically essential.
Ending note: Advocates urged careful drafting to avoid sudden losses of coverage; the department said the language provides the state flexibility if federal match changes but acknowledged the committee’s discretion.
