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Health Care Coverage Reform Initiative Resources

General Information

After working through a comprehensive process for the past year, the SCI team has issued a report containing recommendations to Governor Strickland and the General Assembly about how Ohio should move forward to cover its uninsured residents. A link to the report is found below.

Ohio has been one of 14 states to participate in the Coverage Institute sponsored by Robert Wood Johnson Foundation’s State Coverage Initiatives (SCI) program. The SCI team worked diligently to uncover the facts about Ohio’s uninsured residents, Ohio’s health insurance programs and markets, and the gaps in the current system that cause many Ohioans to be uninsured.

The SCI team also worked closely with the Healthcare Coverage Initiative Advisory Committee, appointed by Governor Strickland, to develop a comprehensive set of recommendations to cover Ohio’s uninsured residents. The SCI team’s recommendations are based on the best available information and the diverse views of those impacted by Ohio’s health care and coverage systems.

Recommendations include:
  • Requiring employers to establish §125 Plans
  • Reinsurance for individuals and small businesses
  • Extending group coverage to dependents up to age 29
  • Premium assistance for low income workers
  • Enrolling more Ohioans in Medicaid
  • Expanding Ohio’s Medicaid to 200% FPL for parents
  • Allowing non-Medicaid eligible adults to enroll in Medicaid managed care plans
  • Reforms to the individual health insurance market

The recommendations were organized to reflect the potential for sequential or partial implementation. Some recommendations may be more readily agreed upon and achieved in the context of limited resources. Other recommendations may be more challenging in terms of the cost and impact. Therefore, implementation of reforms should consider available resources in light of Ohio’s budget situation and the need to mitigate the potential for market disruptions.

Please click here for the executive summary. Click here to view the full report.

Click on the respective link below to view each of the appendices:

Appendix A- Chart , Uninsured Ohioans by Income, Health and Work Status (2007 Expected Estimates)
Appendix B- Chart Uninsured Ohio by Income, Health and Work Status (2004 Firm Size Breakouts, 2007 Expected Estimates)
Appendix C- Ohio’s Fact Pack on the Uninsured (October 1, 2007)
Appendix D- Lewis and Ellis Actuarial Consultants, “ Ohio Health Care Coverage Reform Initiative: Actuarial and Economic Modeling of Health Coverage Reforms" ( June 2008)
Appendix E- McAlearny, Demby and Jamieson, “Report to the Ohio Department of Insurance: Assessing the impact of SCI Policy options on Ohio’s Economy, business climate, labor and uninsured” (2008)
Appendix F- Chart, Mandates and Other Insurance Reforms In Ohio (July 2007)
Appendix G- Ohio’s Basic and Standard Health Insurance Plans for Open Enrollment
Appendix H- Chart of Cost and Coverage Estimates for SCI Team Reforms With and Without an Individual Mandate
Appendix I- Minutes of the Healthcare Coverage Initiative Advisory Committee
Appendix J- Healthcare Coverage Initiative - Benefits Team Report

Lewis and Ellis Healthcare Reform Report Update: Open Enrollment Analysis (February 11, 2009)

About the Initiative

1. Envisioned State of a Healthy Ohio
2. Goals of the Health Care Coverage Reform Initiative
3. The Robert Wood Johnson Foundation, State Coverage Initiatives Coverage Institute
    a. Program description
    b. State of Ohio - Application narrative
    c. Governor’s letter
    d. List of the Ohio team participants
    e. SCI Site Visit Meeting Presentation
    f. Sept. 26, 2007 Meeting Presentation
    g. SCI Meeting Information
   
September 13th SCI Conference Call Information
Agenda Top Priorities Memo
    i. Principles learned at the Chicago RWJF conference (Oct. 9, 2007)
 

Meeting Handouts and Presentations

1.   Presentation: Health Care – Current State of Affairs
2.   Health Care Advisory Committee Reading List
3.   Uninsured Fact Pack
4.   Uninsured Ohioans by Income, Health and Work Status
5.   Uninsured Ohioans by Income, Health and Work Status (2004 Firm Size Breakouts)
6.   Working Draft Inventory Of Reform Options, Programs and Program Expansions
7.   Stakeholder Progress Report Presentation
8.   Benefit Design Presentation (November 20, 2007)
9.   Chart - Health Reform Options (October 30, 2007)
10.  Benefit Plan Options (October 30, 2007)
11.  AC Health Reform Input (October 30, 2007)
12.  Chart - Healthcare Scenarios (October 30, 2007)
13.  Representative List of Uninsured Conditions (October 30, 2007)
14.  Representative List of Ridered Conditions (October 30, 2007)
12. Comparison of Selected States by Health Reform Proposals (12/11/07)
13. Healthcare Financing and its Consequences (12/11/07)
14. HCAP Overview (12/11/07)
15. Ohio Hospital Association Presentation (12/11/07)
16. Benefits Subcommittee Presentation (12/11/07)
17. Achieving Health System Reform in Ohio (12/11/07)
18. Medicaid Overview of Section 1115 Waivers
19. OACHC presentation (12/11/07)
19a. OACHC Defined (12/11/07)
20. Overview of Free Clinics in Ohio SCI
21. UHCAN Presentation Levine local and consumer spending (12/11/07)
22. Health Policy Institute Health Spending: The Good, The Bad, and The Ugly (12/11/07)
23. Estimated Cost for Healthy Families Medicaid Expansion (January 22, 2008)
24. CHAT Powerpoint Presentation (January 22, 2008)
25. Issues for a Merged Individual and Small Group Market Powerpoint Presentation (January 22, 2008)
26. Healthcare Reform Projections (February 14, 2008)
27. Ohio Healthcare Change in Spending Presentation (February 14, 2008)
28. Modeled plan Designs (February 14, 2008)
29. Insured vs. Uninsured demograpics (February 14, 2008)
30. Sample of Rating Changes by Individual and Small Group Markets (February 14, 2008)
31. Outline SCI Team Report (March 6, 2008)
32. Outline - Health reforms for feedback (3-19-08)
33. SCI Draft Recommendations (May 29, 2008)
 

Reading Materials and Other Resources

1. Actuarial/Economic Modeling “Request for Proposal”
2. LIMRA Report on Health Care Consumerism
3. The Robert Graham Center - The Importance of Having Health Insurance and a Usual Source of Care
4. American Academy of Family Physicians - Value of Family Medicine
5. Ohio Business Roundtable Work Plan to Improve Health and Health Care in Ohio
6. Ohio State Medical Association's Vision for Creating a Healthier Ohio
7. Reading List - Benefits
8. State of Ohio High Risk Pool Feasibility Study (June 2005)
9. State of Ohio High Risk Pool Feasibility Study (Supplement May 2006)
10. Charts - Flow of Fund for a Potential High Risk Pool for Ohio (November 2005)
11. Ohio Association of Free Clinics Background Information (12/11/07)
12. Healthcare Glossary
13. SCI - Advisory Committee Feedback (April 24th, 2008)
14. Ohio Family Health Survey