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Ohio Medicaid expansion sign-ups keep crushing projections

By   /   March 21, 2016  /   News  /   No Comments

Part 24 of 27 in the series Ohio's Obamacare expansion

Enrollment in Ohio Gov. John Kasich’s Medicaid expansion remains on track to double projections in the next few years.

When opting to expand Medicaid under the Patient Protection and Affordable Care Act, Kasich estimated that 447,000 Ohioans would sign up by 2020. Actual enrollment was 661,725 in February, based on the latest caseload report from the Ohio Department of Medicaid.

If ODM capped Obamacare expansion enrollment at its current level, the two-year-old program would already be 48 percent larger than the Kasich administration said it would be after seven years.

Before Kasich expanded Medicaid eligibility, a study from Tennessee suggested the expansion — which adds working-age adults with no kids and no disabilities to the welfare rolls — would shrink Ohio’s labor force.

The Republican governor paid no heed to the Tennessee study, and also disregarded an Oregon study published in The New England Journal of Medicine concluding Medicaid expansion had no measurable impact on health outcomes.

Ohio’s Obamacare expansion added far more people to Medicaid than expected in its first year, and enrollment continues to top expectations. February enrollment was 0.1 percent below revised projections from last spring, but the February number will increase in future caseload reports.

ODM initially reported 648,088 Obamacare expansion enrollees in December; because of retroactive and backdated enrollment, the latest report showed 670,773 enrollees in December.

RELATED: Ohio Obamacare expansion keeps getting bigger

Average monthly enrollment for the 2015 fiscal year was 159,000 higher than the Kasich administration projected, based on ODM figures that are likely to increase in coming months. At 662,575, average 2016 enrollment is 3.8 percent higher than last spring’s revised projections.

Kasich portrays Medicaid expansion as a moral obligation that’s affordable because of Ohio’s economic recovery. But since his Medicaid expansion took effect in 2014, enrollment in the welfare program has outstripped job growth by a wide margin.


From December 2013 to December 2015, Ohio’s private-sector job growth rate was 3.6 percent — lower than the national rate of 4.8 percent. Ohio’s labor force growth during the same period ranked 42nd of the 50 states.

Greg Lawson, a policy analyst for the free-market Buckeye Institute, called Ohio’s economic performance in the wake of Kasich’s Medicaid expansion “a mixed bag.”

“On the bad side, as research has shown, Medicaid often reduces the number of hours worked by enrollees,” Lawson told Watchdog.org. “This means that the Medicaid expansion will be a drag on Ohio’s long-term economic performance.”

Lawson said recent labor force growth is a sign of positive momentum for Ohio’s economy, likely triggered by Kasich administration tax cuts. But state lawmakers “will have to either increase taxes or shift spending” to pay the state share of Medicaid expansion costs starting next year.

With Obamacare expansion consistently over budget, state money meant for traditional Medicaid recipients — the disabled, the elderly, children, and pregnant women — will likely be spent on the expansion population next spring.

Last year, when ODM blew through its initial appropriation for the Medicaid expansion, the Kasich administration used spending authority the Ohio General Assembly intended for the traditional Medicaid program to avoid seeking legislative approval to spend more Obamacare funds.

Ohio’s Medicaid expansion has cost federal taxpayers $7.1 billion since January 2014. The expansion’s federal match rate drops to 95 percent next year and is scheduled to decrease gradually to 90 percent by 2020.

The governor’s office did not respond to a request for comment.

Part of 27 in the series Ohio's Obamacare expansion
  1. Obamacare expansion passes Ohio governor’s July 2015 projection
  2. Will Ohioans be taken in by Obamacare Medicaid spin?
  3. Ohio Gov. Kasich wants rubber stamp for Obamacare money
  4. Obamacare adds 450,000 Ohioans to Medicaid rolls
  5. Ohio: Who’s paying for Kasich’s Medicaid expansion?
  6. Ohio budget relies on billions in new Obamacare spending
  7. Ohio Obamacare expansion 33 percent over budget in first year
  8. Two-thirds of Ohio’s Obamacare enrollees are on Medicaid
  9. No money, no problem for Ohio Obamacare expansion
  10. Obamacare puts half a million Ohioans on Medicaid
  11. Ohio lawmakers show no inclination to stop budget-busting Obamacare expansion
  12. Ohio House Republicans embrace Obamacare expansion
  13. Ohio Obamacare expansion costs $3 billion in first 15 months
  14. Ohio’s Obamacare expansion already $1 billion over budget
  15. At $4 billion, Ohio Obamacare expansion blows past projected costs
  16. Ohio’s dependence on Medicaid is the worst in the Midwest
  17. Three-fourths of Ohio Obamacare enrollees are on Medicaid
  18. Ohio Medicaid spending is skyrocketing under Gov. Kasich
  19. Ohio’s Obamacare expansion has cost taxpayers $5 billion
  20. Ohio Obamacare expansion keeps getting bigger
  21. Has Ohio Gov. Kasich really restrained Medicaid growth?
  22. Flashback: Gov. Kasich’s Medicaid expansion end-run
  23. Kasich’s Medicaid expansion has cost taxpayers $7 billion
  24. Ohio Medicaid expansion sign-ups keep crushing projections
  25. How many Ohio Medicaid expansion enrollees have jobs?
  26. Ohio Medicaid expansion costs top $7.5 billion
  27. Ohio’s budget-busting Medicaid expansion trend continues


Jason was formerly a reporter for Watchdog.org