Senate Proposal Improves Health Outcomes For Ohioans
A Guest Column by State Senator Dave Burke
June 22, 2015
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The Senate’s approach to House Bill 64 takes a pragmatic approach to providing quality health care to all Ohioans, while being fiscally responsible to help sustain the system over time. The Senate's Medicaid Committee heard from over 200 individuals from across the state during public testimony. Ohioans shared heartfelt and personal stories with Senate members during public testimony. Fueled by the democratic process, this helped shape the current version of the budget bill.

The Senate made it very clear that combatting infant mortality is a top priority. The Senate's budget proposal incorporates work led by Senator Shannon Jones that will infuse funding and outcome-driven programs to areas with prevalent infant mortality problems. We also restored a provision for the continuation of Medicaid coverage for pregnant women up to 200 percent of the Federal Poverty Level (FPL). Current federal law requires these individuals to be enrolled in a private or exchange health plan, but the Senate feels that until the federal government is able to get their health care program up and running effectively, it is our responsibility to catch those individuals who fall through the cracks. Pregnancy is a story about two people, and an innocent child should not have to pay the toll of a poor choice or an overly complicated law.

The Senate took the responsible approach to respond to the concern from the developmental disability community about the level of funding necessary to meet the demands of the new initiatives in the Governor’s proposal. We increased our investment to fully restore funding for those programs by adding $12 million in Fiscal Year 2016 and $21 million in Fiscal Year 2017. The Senate heard additional concerns over the closure of developmental disability centers and the impact this would have on individual lives. As a result, the Senate supported a provision to form Developmental Closure Commissions. The outpour of heartfelt concern and support of different provisions surrounding this community was truly inspirational, and like the House, the Senate looks to address additional concerns of the developmental disability community in the upcoming biennium.

One of the most important things we have heard from constituents over the years is the rapidly growing cost of Medicaid within the state budget. This is why the Senate rolled the Hospital Franchise Fee back to the level in current law of 2.66 percent. The introduced version of the bill increased the fee to 3 percent and the House increased that to 4 percent. This fee upon hospitals is a direct increase in the cost of care regardless of payer, including those paying in the private market. This change alone resulted in a $1.5 billion reduction in Medicaid spending over the biennium.

Ohio has taken a leading approach to care management and continuing down our policy pathway of value over volume. The Senate's added provision will require 50 percent of Managed Care contracts to be value-based by the year 2020.

On average, individuals with mental illness in Ohio have a life expectancy 25 years less than their Medicaid counterpart. This crisis is something that the Senate feels need to be addressed on a number of fronts, but first and foremost, we must incorporate the physical and mental coordination of health care for this fragile population. The Senate added provisions to integrate behavioral health care services into a managed care model by 2018, while providing oversight from the Joint Medicaid Oversight Committee through the process to ensure a smooth transition of services. This will not only provide better access to mental health services and mature access points to care that do not exist today, but it will largely increase health care equality for our Medicaid population and give them the same access to guided care coordination, that those in the private payer market are already provided.

This is a small glimpse into the continued innovation in the health care arena in the State of Ohio, not only in this budget and in the Medicaid system, but in the health care arena as a whole. Ohio is doing great things and we must continue to support these programs. However, we must accept that not all of our outcomes are positive. We must be innovative and aggressive to improve outcomes. This budget offers a strong foundation for the future and will continue to grow a healthier Ohio.

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