Medicaid proposal means 800,000 adults could lose coverage on some services

COLUMBUS, Ohio (AP) - About 800,000 adults, including older, blind, disabled and pregnant Ohioans, would lose Medicaid coverage for dental, vision, podiatry, chiropractic and psychologist services, under a proposal Gov. Bob Taft outlined Thursday to rein in skyrocketing costs.

Of those adults, about 30,000 parents of children who receive Medicaid benefits would lose coverage entirely because of proposed changes to eligibility requirements.

"We do all of this very, very reluctantly. This is the last thing we want to do," Taft said. Children on Medicaid would not be affected.

In Wednesday's State of the State speech, Taft (pictured, above) proposed eliminating services that the state has the option of providing, freezing the Medicaid reimbursement rates for nursing homes, hospitals and in-home providers, and changing eligibility requirements to reduce the number of people covered.

Taft and Tom Hayes, director of the Ohio Department of Job and Family Services, on Thursday discussed the proposed reforms, some of which the Legislature must approve.

Meanwhile, conservative lawmakers criticized Taft's proposal to raise more taxes, saying Ohio families already pay too much.

Five House and Senate Republicans announced their opposition to the governor's budget-repair proposal. They said the state has a history of overspending and then resorting to new taxes when the economy weakens.

"When times are good and you spend at means you can't sustain, it is not disgusting to come back to reality and spend within your means," said Rep. Timothy Grendell of Chesterland. "Ohio families are having to do that today -- they can't pick the pockets of their neighbors for more money."

Sen. Jim Jordan of Urbana said Taft is going in the wrong direction by trying to increase the already high tax burden.

Grendell and Jordan led opposition to the proposal to raise Ohio's cigarette tax by 50 cents a pack last spring. After a two-week fight, the proposal was reduced to 31 cents per pack.

Taft announced the new tax proposals in Wednesday's speech. He wants the tax increased from 55 cents a pack to $1 to help reduce a $720 million deficit.

He also wants to increase a variety of additional taxes on July 1, including an expansion of the sales tax, raising the gasoline tax and broadening the state's business taxes by eliminating some exemptions.

Hospitals and nursing homes are among the groups bracing for Taft's proposed freeze in Medicaid reimbursements.

Taft said Medicaid expenses contributed to a $720 million state budget deficit for the current year and will have grown from a $6 billion annual expense to a projected $10 billion by June 2005, the end of the next two-year budget.

On top of sluggish revenues, "mandated Medicaid spending has once again spiraled out of control," Taft said.

Freezing Medicaid spending could affect more than Medicaid patients, said Mary Yost, a spokeswoman for the Ohio Hospital Association.

Reductions in Medicaid could force hospitals, often one of the largest employers in their communities, to lay off staff, reduce the number of procedures they offer or even close, Yost said.

"When hospitals have to reduce services, less money is spent on other goods and services," she said.

Medicaid helps pay for health care for low-income people, mainly older Ohioans and those with disabilities. The federal government reimburses a percentage of a state's expenses, with the amount varying from year to year.

Costs are skyrocketing as people live longer and demand service increases. All states except Alabama have cut spending or plan to cut spending this year on Medicaid, according to a report released last week by the Kaiser Commission on Medicaid and the Uninsured.

That includes 32 states that made cuts when the fiscal year began last summer and have found it necessary to cut yet again.

Peter Van Runkle, executive director of the Ohio Health Care Association, said a rate freeze would cut funding about $475 million for nursing homes and $49 million for facilities housing people with mental retardation or developmental disabilities.

Van Runkle said a long-term solution is needed on both the federal and state levels.

"You can't just monkey with the program and expect there to be no impact. To say that the answer is 'well, we're just going to cut,' that's short-sighted," Van Runkle said.

Taft said the long-term solution lies in Washington. He called on Congress to reform the system.

(Copyright 2003 by The Associated Press. All Rights Reserved.)