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Ohio Medicaid Pursues Work Requirements

Last week, the Ohio Department of Medicaid (ODM) and Office of Health Transformation (OHT) announced they will seek federal approval to implement a work requirement as required by State FY 2018-19 budget bill (HB49) and guidelines by CMS. According to information released by OHT, most of the 700,000 Ohioans enrolled in the Medicaid expansion work – 58 percent earned income in the previous year and 44 percent currently meet the work requirement. Additional enrollees are exempt from the requirement based on Ohio law and new federal guidelines. As a result, an estimated 95 percent of the current Medicaid expansion population will meet the work requirement or be exempt, and the remaining 5 percent – about 36,000 individuals – will need to seek work or otherwise comply with the requirement to remain enrolled in Medicaid.

On a Medicaid coalition call last week with Office of Health Transformation Director Moody, Medicaid Director Sears and Medicaid staff, Director Moody stated that there would be exemptions for individuals 55 and older, those with chronic health conditions, individuals enrolled in school or occupational training, those participating in an alcohol or drug addiction treatment program per ORC5166.37. ODM estimates approximately 36,000 Ohioans would need to demonstrate they meet the exemptions, or show proof of work to continue to be eligible for Medicaid. New enrollees must meet the requirement when they enroll, and current enrollees must meet the requirement during their next annual redetermination.

There will be a 30-day public comment period, before ODM finalizes the work requirements prior to sending to the package to Centers for Medicare & Medicaid Services (CMS) for approval. Ohio is expecting it will be able to go-live on July 1, 2018, thought this depends on the response from CMS.

While most of the individuals served by LeadingAge Ohio members will be exempt from this work requirement, it represents a significant policy change for Ohio’s Medicaid program. To review a fact sheet about the work requirements prepared by ODM, please click here. Any questions may be directed to Nisha Hammel at

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