The story of Ohio’s high-risk insurance pool provides a teachable moment for proponents of Medicaid expansion.

Like the rest of Obamacare, the pools have been plagued with problems from the start with costs far outpacing expectations and with states like Ohio battling the federal government over eligibility issues. Federal funding for the high-risk pools ran low earlier this year and were closed to new enrollment as a result.

Keeping the high-risk pools open to current participants has been complicated by negotiations with the federal government.  The AP reports the feds offered Ohio new contract terms in April of this year, but came in $12 million below what Lt. Governor and Director of Insurance Mary Taylor needed to maintain current coverage for the 3,500 Ohioans on the plan.  Since the parties were unable to come to terms, the federal government will assume control of Ohio’s pool which could mean problems for its participants.  As Mary Taylor writes in a letter to US Health & Human Services Secretary Kathleen Sebelius, “Changes to benefits, treatment plans, deductibles, access to provider networks, and a potential lapse in coverage later in 2013 could harm consumers relying on the high-risk pool for their health care needs.”

The inability of the federal government to fully fund Ohio’s high-risk plans should give pause to lawmakers in the Buckeye state when considering Obamacare’s Medicaid expansion.  Proponents of expansion cite as one of its primary benefits 100% federal funding for three years, tapering off to 90% thereafter and saving Ohio a projected $13 billion.  The federal funding promise, however, is a hollow one to expansion opponents, and even more so now that we witness the Obama administration and the state of Ohio bickering over $12 million.  How can we rely on the promise of $13 billion from the federal government to fund hundreds of thousands of people eligible for Medicaid expansion, if we are denied $12 million for the 3,500 participants in Ohio’s high risk pool?  It’s a question worthy of some serious thought given state lawmakers inability to let the expansion question lie.

Those fighting Medicaid expansion should take confidence in their position as the facts and figures are on their side.  Please make sure your State Rep and State Senator know it.  Contact your Ohio Assembly leaders and ask them the simple question, “How can Ohio count on $13 billion from the federal government for Medicaid expansion, if the feds won’t give Ohio an additional $12 million to cover our most medically at risk population, the very population for which Obamacare was created in the first place?  If State Reps and State Senators are forthright in their response, we should hear crickets because the answer simply is, Ohio can’t.

Additional reading:

AP News Break:  Feds to Run High-Risk Pool in Ohio