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Changes coming to Ohio Medicaid will require participants to actively pick a plan each year

Posted at 5:44 PM, Jan 27, 2022

COLUMBUS, Ohio — If you are one of the roughly one in four Ohioans who get their health coverage through the state’s Medicaid program there are changes coming your way this year that will require you to play an active role in selecting your coverage each year from here on out.

The “Next Generation” overhaul set to launch in July gets rid of the automatic re-enrollment and has been three years in the making. It is designed to improve efficiencies in the system and administrative cost savings while getting Ohio’s roughly 3 million Medicaid users more involved in their own healthcare choices which can lead to healthier outcomes.

If you don't select a plan, you’ll still have coverage — it’s just an algorithm will be used to do it for you.

"We found that it could result in 2 million or more Ohioans experiencing a change in healthcare coverage,” said Desiree Tims, President and CEO of Innovation Ohio Education Fund. The group released an analysis of the changes in a 17-page report. They are concerned about the lack of information that has gone out for something happening so soon and impacting so many.

"So far the department has only laid out a timeframe for this change to happen but they still aren't saying how consumers will be notified that they need to select a new plan,” Tims said.

And if they don't select a new plan and one is assigned for them, that could cause disruptive changes, argues Franklin County Commissioner Erica Crawley, "including having to change doctors, finding a new pediatrician for their child or a new hospital system,” she said.

Most concerning for Crawley is the fact that those reliant on Medicaid are from already under-served communities that are often difficult to reach.

On top of that, she says the state's track record on handling big projects like this in a short period of time points to a need for a delay in this transition.

“This is the same state government that was an abject failure on processing unemployment for those who needed it during the pandemic,” Crawley said. "To put it bluntly, the change in the enrollment practice is essentially a group of administrators saying they are going to reach out in an undetermined way to a group of people who can be hard to get a hold of, as I said mainly transient, and if they don't hear back they are going to change their healthcare."

In a statement last year announcing the go-live date of July 1, 2022, Ohio Medicaid Director Maureen Corcoran said “our priority since the beginning of this administration has been on doing this right for the people we serve,” adding at the time that “a July 2022 go-live gives us time to support and inform our members about the new program, to work with community leaders, and respond to feedback received from the plans and providers.”

The Ohio Department of Medicaid did not return emails requesting comment on how the rollout will work, how the state’s Medicaid users will be notified beforehand, or whether counties will be given additional resources to aid in the effort.