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July 2008

Ohio Health Reform Recommendations

On July 23, 2008 an advisory group appointed by Governor Strickland produced a comprehensive report that included recommendations for meeting two goals set by the governor —to reduce the number of uninsured Ohioans by half and to increase the number of small businesses able to offer coverage to their workers. This report was the work of the 12-member team selected to participate in the Coverage Institute hosted by the State Coverage Initiatives (SCI) program at AcademyHealth and funded by the Robert Wood Johnson Foundation. They were aided in their work by the larger Healthcare Coverage Advisory Committee that included nearly 50 representatives from stakeholder groups.

The recommendations in the report include:

  • Recommendations Focused on Employer Sponsored Coverage:
    • Reinsurance program designed to reduce the cost of coverage by about 25 percent for eligible small businesses and individuals;
    • Premium assistance for low-wage workers;
    • A requirement that employers offer Section 125 premium-only plans; and
    • Coverage for dependents up to age 29.
  • Recommendations Focused on Covering Lower Income Ohioans:
    • Increase enrollment in Medicaid among those currently eligible;
    • Expand Medicaid to 200 percent of the federal poverty level for parents; and
    • Allow adults who currently are ineligible for Medicaid to buy into Medicaid managed care plans with state subsidies.
  • Recommendations that Reform the Ohio Insurance Market:
    • An individual mandate to purchase coverage for those who are able to afford it;
    • Guarantee issue in the individual market;
    • Increasingly progressive rating rules to reduce the variance in insurance premiums;
    • Subsidies to help low income individuals afford private coverage; and
    • An insurance connector to implement coverage expansions.
  • The report also includes recommendations to improve value in the health care system and hold down costs, including adoption of health information technology, transparency and reporting requirements, and wellness strategies.
  • The Advisory Committee recommended that funding for health reforms come from current sources where possible and—where this is not possible—from a broad base of funding sources. The funding mechanism adopted should reflect the principle of shared responsibility.

Ohio’s SCI team report is now in the hands of Governor Strickland and leaders in the Ohio General Assembly. Decisions about moving forward with the recommendations will be made in the coming months as Ohio prepares for consideration of its next biennial budget to be introduced in January.