The State Budget and Health and Human Services
A look at how Ohio spends taxpayer dollars reveals that the three biggest expenses are Medicaid and other health and human services, K-12 and higher education, and justice and public protection. Some budget watchers even quip that the state’s top three priorities are to medicate, educate, and incarcerate.
Joking aside, it’s clear that health and human services account for almost 50 cents of every dollar spent out of Ohio’s General Revenue Fund (GRF), the primary “cash register” for state government. There’s good reason for that. Medicaid now covers one of every five Ohioans and one of every three Ohio children. It pays for 28% of all hospital care and 47% of nursing home care. It provides food for the hungry and shelter for the homeless. It protects the elderly and supports people with developmental and behavioral disabilities. And it even brings dollars into the state from the federal government. Every time Ohio spends $1 of its Medicaid budget, it draws down roughly $2 in matching federal dollars.
Still, in hard economic times, health and human services are often the first line items to be cut or eliminated – even though the number of Ohioans becoming eligible for Medicaid is on the rise as people lose their jobs, their health insurance, and their homes. The spending program first on the chopping block is actually the one needed more and more by struggling individuals and families. Medicaid spending is expected to grow through 2013 as a larger number of Ohioans lose their ability to be self-sufficient – taking a bigger and bigger chunk out of the state budget.
In the biennial budget that began July 1, 2011, important policy decisions were made that will support vulnerable Ohioans in the next two years:
- Medicaid eligibility and optional services (vision, dental) were maintained;
- Home- and community-based long-term care services for seniors were prioritized over institutional care;
- Medicaid match for behavioral health services was elevated to the state as a first step in integrating physical and behavioral health care;
- The Ohio Housing Trust Fund was preserved despite attempts to redirect funding for affordable housing to county recorders;
- Funding for adoption subsidies in child welfare was maintained;
- Funding for Federally Qualified Health Centers was maintained; and
- Access to early childhood services, such as child care and home visiting, was maintained for all currently enrolled families.
Despite these successes, many children, families, seniors, and people with disabilities will be vulnerable over the next two years. Funding for mental health and addiction services remains woefully inadequate. Local government social services were slashed. Waiting lists persist for long-term care supports for people with disabilities.
Advocates for Ohio’s Future will be monitoring implementation of the FY2012-13 budget and will be working to secure additional resources for our struggling neighbors, friends, and families. Learn the basics about how the budget process works.
If you want in-depth information about the state budget and how health and human services are funded, check out these links: