Toledo Blade...
Medicaid decision could widen care gap
600,000 in Ohio could be without coverage
By Catherine Candisky, Columbus Dispatch 

COLUMBUS -- If Gov. John Kasich decides against expanding the state’s Medicaid program, more than 600,000 of the poorest Ohioans could remain without health insurance while those with slightly higher incomes would qualify for subsidies and tax credits to buy private coverage. 

The potential gap was created last month when the U.S. Supreme Court, while upholding most of the federal health-care law, tossed a requirement that states expand Medicaid or face federal sanctions. 

The health-care law was designed to cover about half of uninsured Americans through Medicaid by expanding eligibility to those earning up to 138 percent of the federal poverty level, largely childless adults with incomes under $15,000 a year. 

The rest would be required to purchase private coverage starting in 2014 -- a mandate upheld by a majority of the justices -- with subsidies and tax credits for those earning 100 to 400 percent of the poverty level. 

That means those under the federal poverty level -- in the absence of a Medicaid expansion -- would get no state coverage and no help buying private insurance. 

In, Ohio, an estimated 789,000 uninsured were to be covered through a Medicaid expansion, including 627,000 with incomes under the poverty level. 

Mr. Kasich, like many governors, is on the fence, considering his options. 

Although the federal government will pay expansion costs the first three years and at least 90 percent after that, the added expense down the road for states already struggling to pay budget-gobbling Medicaid tabs will be weighed against leaving the poorest without health insurance. 

“If we don’t expand [Medicaid], those under the federal poverty level will not be able to utilize tax credits,” said Maureen Corcoran, former Ohio Medicaid director and president of Vorys Health Care Advisors in Columbus... 

Read the rest of the article at the Toledo Blade