Budget Priority Deep-Dive: Medicaid Double Edition

by: Sarah Hudacek, AOF Policy Associate

Budget priorities: Expand general Medicaid eligibility up to 300% FPL for families and children AND Allow for continuous Medicaid coverage for children up to six years old

Medicaid eligibility is incredibly complex. There are almost a dozen different pathways into Medicaid coverage, each with their own eligibility requirements. Currently, eligibility for pregnant women is capped at 200 percent of the federal poverty level and eligibility for children up to age 19 is capped at 206 percent of the federal poverty level.

Last September, Governor DeWine announced the Bold Beginning Initiative, which included the priority to expand eligibility for pregnant moms and children under age 19 up to 300% of the federal poverty level - a priority that was included in the Governor’s Executive Budget proposal. AOF supports this provision, which will expand access to important health care services for an additional 30,000 children and an estimated 3,500 pregnant people in Ohio.

Continuous Medicaid coverage for children means that once a child enters the Medicaid program, they can remain on the program even if their family’s eligibility situation changes. Families receiving Medicaid coverage and earning close to the eligibility limit often experience fluctuations in their incomes that could result in them entering, leaving, and re-entering the Medicaid program on an endless cycle. Allowing children under age 6 to remain on the Medicaid program even if their family’s income fluctuates above the eligibility limit would ensure that Ohio’s youngest children have continued access to health screenings, developmental checks, and doctor’s visits needed to ensure their health and well-being for the rest of their lives.

We know that children who fall behind in vital benchmarks tend to stay behind. Including continuous coverage for children up to age 6 is a vital piece of a family-focused budget.