New bipartisan bill aims to save Medicaid costs

OHIO — Many Ohioans can no longer afford to get sick because of rising health care costs.

A new bipartisan bill is seeking to change that, and lawmakers are proposing to make the Medicaid model simpler, saying this move would save millions of dollars per year.

The goal is to eliminate some of Medicaid’s administrative costs by eliminating what lawmakers called “the middleman.”

Doctor John Ross from Healthcare for All Ohioans said the system hasn’t been working for far too long. 

“People would call a wicked problem right, one that’s really really hard to solve…first of all people’s lives are on the line, you’ve got a lot of money on the line and we’ve got a lot of vested interests,” Ross said. “We got 30 million uninsured, half of us unsure whether insurance is even going to cover us if we have a serious event, that’s not good.”

Ross said over the last five decades the number of people who are in administrative roles grew 40 times more, while doctors and nurses nearly doubled.

“Every one of those people working in the insurance offices who are trying to not pay the money, have somebody in the doctors’ and hospitals’ offices who are trying to get the money,” Ross said. “And we’ve got lawyers behind the scene to even decide whose bill it is to pay.”

This complex system is why lawmakers from both sides of the aisle are sponsoring the Medicaid Savings Act.

The bill would move the Department of Medicaid from a Managed Care Organization (MCO) model  to an Administrative Services Organization (ASO) model.

“Remove one of the middlemen that we know take at least roughly 15% of the Medicaid dollars without showing us that they’re decreasing costs or improving outcomes,” said State Sen. Beth Liston, D-Dublin.

State Sen. Louis W. Blessing III, R–Colerain Twp., said that this is a model that’s currently operating in Connecticut.

“The net effect of this in Connecticut was over the course of 13 years they saved $4 billion,” Blessing said. “Because again, when you have this system of significant administrative overhead, you have a lot of profit in the MCO system that is now actually going towards health care outcomes for this.”

Lawmakers said it could save Ohioans between $450 and $850 million each year.

State Rep. Karen Brownlee, D-Symmes Twp., who’s also behind this bill, said the impact for patients will be huge.

“By how we streamline, how we deliver health care to the three million Ohioans who are on Medicaid,” Brownlee said. “The changes proposed in this bill will ensure that more taxpayer dollars will be spent on direct patient care and less on administrative costs for the insurance companies that administer these programs.”

The biggest change Liston said is that it would be easier for Medicaid patients.

“They’d all be on the one Medicaid system,” Liston said. “So, it’s easier for them to know who to contact, what’s covered.”

The bill is also meant to incentivize primary care doctors so that more people will accept Medicaid patients.

Ross said it’s time to think about what’s missing within the health care system.

“This is an opportunity not just to expand access and save some money; it would allow us to actually improve care for this vulnerable population,” Ross said.