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Medicaid Re-authorization

Recently, the former Medicaid expansion coalitions regrouped and are now working on Medicaid Re-authorization.   This campaign will not be any easier than the original one was that did result in the expansion of Medicaid in Ohio, but only for the term of the current budget biennium.   Without further action of the General Assembly, the Medicaid program will revert back to its original form and almost 400,000 Ohioans will lose coverage.

The number of Ohioans who gained health coverage under the expansion is tremendous.   The work that we did as an organization and our support for the expansion has made a positive difference in the lives of almost 400,000 people.   That is no small achievement and it is something we should be proud of for our participation.  In addition to those who were newly eligible, an additional 250,000 Ohioans who were previously eligible were signed up and now have coverage.  The state reports that they have connected 93% of those they expected to be eligible with Medicaid benefits.

On the Marketplace the story is quite different.   Only 19% of those thought eligible for Marketplace insurance plans have signed up for coverage.   No reasons were given for the lack of participation.

Of those who have obtained coverage under Medicaid and who had been without coverage for a long time, the following characteristics have been noted:
  • There is a high rate of patients with untreated multiple chronic conditions.
  • Many have mental health issues.
  • Most don't know how to navigate the health care system and this is what causes inappropriate use of the ER for primary care. 
The issue of access still exists.   State Medicaid Director John McCarthy addressed that issue with the Akron /Canton Medicaid Coalition.   According to McCarthy, it is a business decision on the part of the primary care providers that is affected by a large amount of uncertainty.   There are three main issues that affect the willingness of providers to participate:
  • reimbursement decreasing
  • uncertainty of continuation of Medicaid in Ohio
  • Repeal and Replace ACA rhetoric during the election
They can't see investing their energy and resources if the plug will soon be pulled. 

Both McCarthy and presenters on the recent Advocates for Ohio's Future Webinar on the topic stated that they expect Kasich to include the expanded Medicaid program in his next budget.   The question is what will the Legislature do?   McCarthy says there is still much opposition in the House and they are talking of further "reform."
The "reforms" they are most interested in are those enacted in Arkansas, where they used Medicaid money to purchase private insurance for recipients, and Indiana, where they put all Medicaid recipients in Health Savings Accounts.   There are numerous problems with this, beginning with the fact that they are very unaffordable to people.

Without saying it, McCarthy made it plain that the opposition to continuing the Medicaid program is ideological in nature and is not affected by facts and figures. 
What Steps Should We Take?

The biggest need right now is to put a human face to this issue.   All the coalitions will be working on collecting stories from those who have been positively affected by the expansion of the Medicaid program.   I would urge SPAN members to actively seek out those stories.

Story Collection Guidelines

What questions should be asked?   What information are we looking for?   Some guidelines are included here:

"Before" questions:
1. What was your health situation prior to having Medicaid/coverage?
2. What was your employment situation prior to having Medicaid/coverage?
3. Were there other causes for not having health coverage or having insufficient coverage (for example, major life change)?

Try to provide details that would help readers understand that not having health coverage could happen to anyone. This may help readers relate to the challenges that the storytellers faced
"After" questions:
1. Has your health situation changed since having Medicaid/coverage? If so, how?
2. Did your financial situation change after you obtained Medicaid/coverage? We’ve heard from many families that they could spend more on other necessities, like food, housing, child care, or getting repairs done.
3. Has your employment situation changed at all? If so, how?
4. What difference has having coverage made in your life? (This helps us get specific quotes tying their experience directly to the program.)

Stories that are obtained should be submitted to Ohio Speaks at this website:


We are no longer referring to this as Medicaid expansion as the expansion has taken place.   We are emphasizing continued health care access through the Medicaid program.  

Meeting with Legislators

Now that the election is over would be a good time to start meeting with legislators.   Director McCarthy stated that it would be just as effective to meet with legislators at home, rather than in Columbus.   The reason for this is that the legislators commented that organizations flooded their offices about the topic, but at home no one seemed to care about it.  You can schedule an in district (at home) meeting with your legislator by calling their Columbus office and requesting a meeting in district.  You can look up your representatives here:  House Members   Senate Members
  • Emphasize the need for continued access to health care.
  • Use personal stories if you can.
Host a SPAN Speaker!
SPAN speakers are available to come to your club, organization, union or neighborhood gathering. To schedule a SPAN speaker, contact State Director Debbie Silverstein at or 330-673-8524.
Happenings Around the State

SPAN members have been busy.   State Director Debbie Silverstein and Dennis Slotnick, regional coordinator for Region 2, recently attended a meeting at AFSCME Council 8 in Toledo and made a presentation.  Several signed up to get active with SPAN and two additional presentations will be scheduled as a result
SPAN Activist Bob Krasen held a house party to talk about issues in health care at his home in Columbus.

SPAN Council members Matt Noordsij-Jones and Kathy Lambes held an open house at their home in Dayton for conversation about health care.

Bill Davis, regional coordinator for Region 7 presented a showing of the short version of The Healthcare Movie at Northminster Presbyterian Church in Springfield, OH with a discussion afterwards.

A screening of Remote Area Medical, a film about the program, was shown in Dayton with a panel discussion held afterwards.  Along with two film makers who worked on the movie, one of SPAN's State Council members, Matthew Noordsij-Jones, MD, was on the panel.

SPAN members from Toledo, Cleveland, Akron, Columbus, and Athens are working with the Medicaid Coalitions to continue access to care.

Arlene Sheak, regional coordinator for Region 3, and Warren Haydon did a program with The Healthcare Movie for Athens PERI.  This led to a meeting with PERS health care policy staff. 

Region 3 held their Walk for Health on November 6th in Athens and were interviewed for WOUB TV news!
The Healthcare Movie
Do you want to see The Healthcare Movie or schedule a showing in your town? Contact us at
Upcoming Events

The Cleveland Labor Committee will meet on November 8th to discuss strategy.  For more information contact State Director Debbie Silverstein at
SPAN State Council meets again on December 6th in Columbus.  The meeting is from 10:00 am until 1:00 pm and will be held at the First Unitarian Universalist Church in Room 7.  The church is located at 93 W. Weisheimer Road.  All are invited to attend.

A House Party Fundraiser is being planned in Toledo for January, 2015.  For more information, contact Dennis Slotnick, Regional Coordinator, at

Health Care for All Ohioans
Health Care for All Ohioans is the educational arm of SPAN Ohio.  It is a registered 501(c)3 organization with the IRS.  Health Care for All Ohioans will be conducting the educational programs of SPAN such as supplying speakers, tabling, outreach and research.
One of the things Health Care for All Ohioans would like to do is an economic impact study for the State of Ohio.   This study would examine the economic impact an improved Medicare for All system of health care would have on the state.  Items considered would be the costs of care now versus those in a Medicare for All System, the effect on jobs, the effect on state revenue and savings to business and individuals.   Similar studies have been conducted in other states and have always been favorable to a Medicare for All system, but we feel it is important to have information specific to Ohio.

Donations to help us fund this study ARE tax deductible.  Please visit our web page to make a donation or you can send it to:

Health Care for All Ohioans
c/o Barbara Walden, Treasurer
31100 Cedar Road
Pepper Pike, OH   44124-4433
Copyright © 2014 Single-Payer Action Network Ohio (SPAN Ohio), All rights reserved.

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