House likely to reject Kasich change to program helping state’s … – The Columbus Dispatch

Jim Siegel The Columbus Dispatch @phrontpage

Facing a wave of opposition from medical professionals and families caring for the states sickest children, House Republicans plan to strip from the budget proposed changes to the Bureau of Children with Medical Handicaps.

As part of his two-year, $66.9 billion budget, Gov. John Kasich proposed eliminating the bureau, slashing income eligibility in half for babies born after July 1, and shifting the program into Medicaid managed care.

The bureau screens providers, assuring a broad network of experienced and available specialists, said Dr. Jim Duffee, who testified to lawmakers on behalf of the Ohio Chapter of the American Academy of Pediatrics.

Medicaid managed care plans do not have a similar provider network and cannot guarantee continuous care by qualified specialists, he said.

The bureau pays for medicine, treatment and services not covered by insurance for more than 41,000 children with conditions such as cystic fibrosis, epilepsy and cerebral palsy.

Duffee said it is well positioned to fill a gap when confused and anguished parents are told their child has a serious developmental disorder. The cumbersome preauthorization process of Medicaid managed care often serves to delay or even deny timely, appropriate evaluation or treatment.

The Kasich administration has stressed the need to make the program more efficient and deal with an $11 million projected budget shortfall this year.

Rep. Mark Romanchuk, chairman of the House Finance subcommittee that has been hearing testimony on health issues, said that in discussions with administration officials, it became apparent there may be a need to study changes to ensure the program is sustainable.

But the Kasich proposal is too big, too complicated and impacts too many children to handle as part of a budget that also includes hundreds of other issues, the Mansfield Republican said. The subcommittee will recommend that the bureau provision be removed.

Its a big enough change where its very difficult to study it properly and make these kinds of decisions in such a short time Romanchuk said. It didnt make sense to have it in the budget and try to get it done there.

Plus, Romanchuk said, lawmakers should probably slow down everything that touches Medicaid until theres more certainty about what Congress plans.

If Washington caps state Medicaid expenses, it may not make sense to throw another program into Medicaid that will be used to calculate that cap, he said.

The Ohio Department of Health operates the bureau for families with incomes up to 500 percent of the federal poverty level, $123,000 a year for a family of four. Under Kasich's plan, it would move to Medicaid, the tax-funded health insurance for the poor and disabled, with eligibility cut to 225 percent of the poverty level.

Lawmakers have heard from multiple opponents, including Jennifer Fountain of Upper Arlington, whose son, Hudson, was diagnosed in 2014 at age 4 with acute lymphoblastic leukemia after he had showed unusual fatigue, bruising and eating habits.

If her son was impacted, she said her household income would fall just outside Kasichs proposed 225 percent federal poverty guideline. I do not want to see hard-working parents like us, nor their CMH-dependent children, like mine, fall through the cracks, she said.

Her son has endured countless tests and treatments. A new antiviral medication taken three times daily to prevent another shingles outbreak will cost of $621 per 21-day supply.

Its tough enough to fight childhood cancer amid todays vastly changing insurance markets and healthcare landscape we dont need another coverage issue to contend with, Fountain said.

Do not take away the only constant companion many of our Ohio families have been able to rely on in caring for our chronically ill and medically fragile children.

Romanchuk expects a separate bureau bill will be introduced later this year to continue the conversation.

"We look forward to continuing discussions with legislators to find ways to ensure that we can sustain this program for Ohio's most vulnerable children," Kasich spokeswoman Emmalee Kalmbach said in a statement.

jsiegel@dispatch.com

@phrontpage

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