Ohio aims to modify Medicaid waiver to include monthly contributions, create HSAs to cover deductibles, copayments

August 16, 2016

Ohio's Section 1115 waiver application proposal includes a number of changes that would affect Medicaid beneficiaries. The state wants to modify its existing waiver and to change coverage for non-expansion parents, pregnant women and other traditional Medicaid adults. Changes include:

  • Creating HSAs, which would be used to pay a $1,000 annual deductible and copayments at maximum state plan amounts;
  • Imposing monthly contributions, equal to the lesser of 2% of annual income or $99 per year, as a condition of eligibility for all beneficiaries except pregnant women and those with zero income;
  • Establishing a healthy behavior program that would allow beneficiaries to earn HSA dollars to fund copayments or medically necessary services that aren't covered by Medicaid;
  • Allowing beneficiaries to carry forward any monthly contributions remaining in their HSAs to reduce the next year's required contributions; beneficiaries also could carry forward any remaining healthy behavior incentive and deductible funds if certain preventive services are received;
  • Allowing beneficiaries who lose eligibility due to increased income to transfer remaining HSA funds into a separate account to pay private health insurance costs; and
  • Referring beneficiaries working fewer than 20 hours per week to a workforce development agency.