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A New Report Shows That Ohio's 2013 Medicaid Expansion Helped Nearly 300,000 People Get Work

Over 83 percent of employed Ohioans who were continuously enrolled in Medicaid said the program helped enable them to hold down jobs.
Pierre Brunie, a family doctor, examines a patient at his office, on January 29, 2013 in Eglisneuve-d'Entraigue.

In 2013, Ohio Governor John Kasich bucked his fellow Republicans by executing a successful campaign to expand Medicaid in the state under the Affordable Care Act. The expansion met quite a bit of hostility within the GOP; one group of Republican Ohio state representatives tried suing to overturn the expansion, though their effort ultimately failed. Kasich, ever the faithful Christian, apparently told a fellow legislator, "When you die and get to the meeting with Saint Peter, he's probably not going to ask you much about what you did about keeping government small. But he is going to ask you what you did for the poor."

A report released this morning by the Ohio Department of Medicaid suggests that, on this front, Kasich has done quite a bit. The report—which analyzes coverage and employment, financial hardship, and physical and mental health across Medicaid beneficiaries—finds impressive outcomes among recipients continuously enrolled in the program.

Here are four of the most interesting takeaways from the report:

Medicaid Made It Easier for People to Hold Down a Job

Over 83 percent of employed Ohioans who were continuously enrolled in Medicaid said the program helped enable them to hold down jobs; in many cases, Medicaid allowed them to obtain treatment for health conditions that would have otherwise made working difficult. Among unemployed but continuously enrolled beneficiaries, 60 percent said the program made it easier for them to look for work.

A good many former Medicaid recipients also successfully transitioned off the program due to an improved employment situation. Kasich proudly tweeted earlier today that approximately 290,000 Ohioans who had utilized Medicaid were able to leave the program after landing a new job or raise.

The report reaffirms past data suggesting the majority of Medicaid recipients are indeed either working or looking for work. It found almost 94 percent of continuously enrolled beneficiaries were "either employed, in school, taking care of family members, participating in an alcohol and drug treatment program, or dealing with intensive physical health or mental health illness."

Medicaid Improved Financial Stability

While Ohio's continuously enrolled beneficiaries are generally low-income and vulnerable to financial stability—with almost half reporting "strained family budgets" and "housing instability"—almost 30 percent of enrollees reported an improvement in their financial situation since enrolling in the program (compared to 7.7 percent who reported a worsening in their financial situation). Continuously enrolled beneficiaries were also less likely to have medical debt.

Among continuously enrolled beneficiaries who are also parents of young children, 57.6 percent reported that the program "made it easier to buy food and pay rent or a mortgage."

Enrollees Used the Emergency Room Less Frequently

Over time, continuously enrolled beneficiaries' use of the emergency room declined. Meanwhile, the percentage reporting a non-ER source of usual care increased.

Medicaid Improved Physical and Mental Health

Continuously enrolled beneficiaries are much more likely to report that their physical and mental health has improved since enrolling in Medicaid (although the majority reported no changes to either physical or mental health). The report notes that, in qualitative interviews:

Many Group VIII enrolled respondents reported that their Medicaid coverage: 1) was perceived as potentially lifesaving; 2) facilitated a better state of wellness; 3) was beneficial to mental health; 4) enabled participation in preventive health and mental health services; 5) aided in relief of psychological distress related to health concerns and socioeconomic circumstances; and 6) fostered better life functioning (e.g., work, family participation, and community engagement).

But Mental-Health Issues Are Still a Big Barrier to Employment

Almost one in three continuously enrolled beneficiaries in Ohio meet the criteria for a diagnosis of depression and anxiety. Only 26.9 percent of those meeting the criteria for depression or anxiety reported being employed, and almost 90 percent said that "their condition kept them from work or other usual activities for 7 days or more in the last month." Some enrollees with depression or anxiety also reported difficulties obtaining needed treatment. While 86 percent said that accessing mental-health treatment was "not a problem," beneficiaries with depression or anxiety were more likely (than those without mental-health conditions) to report difficulties getting prescription medicine and accessing mental health and other medical care.