March 17, 2026 · Medicaid Committee · 1,568 words · 5 speakers · 16 segments
I call this meeting of the House Medicaid Committee to order. Please rise for the Pledge of Allegiance. I pledge allegiance to the flag of the United States of America and to the republic for which it stands, one nation under God, indivisible, with liberty and justice for all. Thank you. To my committee, I apologize for the back and forth this week, and I thank you for your patience as we navigate bills and such with our business to be done. So thank you for your understanding. Will the clerk please call the roll? We will proceed as a full committee. The minutes from the previous meeting are on your iPad. Please take a moment to review the minutes. Are there any objections to the minutes? Without objection, the minutes are approved. I would like to call forward House Bill 508 for its fourth hearing. All right.
I move to amend House Bill 508 with Amendment 1946. And what the amendment does today is the amendment changes in the Bill 508. There is an ability for the nurse practitioner to collaborate with a physician or a fellow advanced practice nurse practitioner. This amendment requires the collaborative agreement with the advanced nurse practitioner to have a nurse practitioner with at least 10 years of experience. And that is what this bill does to provide more experience with that nurse practitioner.
Are there any objections to the amendment? Without objection, the amendment becomes part of the bill. All right. This will conclude the fourth hearing on House Bill 508. I would like to call forward House Bill 318
for its third hearing.
Chair, I move to amend House Bill 318 with Amendment 1756-1.
Will you please explain the amendment to the committee? Yes, thank you, Chair. This is a pretty short amendment. What it does is it puts a cap of $150,000 that the 75% of the lien would be applied to and any property that is valued over 150 the maximum would be the actual assessed value of the property The other change in this amendment is it takes from of an estate down to of an estate that would not be collectible at all
All right. Are there any objections to the amendment? Without objection, the amendment becomes part of the bill. House Bill 318 did not receive any opponent testimony. Is there anyone present who would like to testify before this committee? All right, this will conclude the third hearing for House Bill 318. I would like to call forward House Bill 581 for its second hearing. And I would like to call on Christine Brown to provide proponent testimony.
Thank you, Representative Gross and members. I want to share with all of you that this, of this $20,000 income disregard from changing to only being at $20,000 for earned and now going into a flexibility of $20,000 for earned $20,000 in between earned, unearned, or combination. I have my friend and others that are at risk that if we don't get this resolved, we'll be forced in nursing facilities or ICFs. And you will see on the PowerPoint some very key issues. The $20,000 disregard is almost 20 years old, but we are not asking for an increase. The key is flexibility. And the one thing is that I have in here for clear language what counts and doesn't count. And also, the average cost of somebody who's like on a self-waiver is $24,432 a year or $2,036 compared to the ICF cost is $193,789 or $16,149. That is gigantic in dollars amounts. And the Medicaid reimbursement or the Medicaid rule to stay in the community if we don't have this flexibility is at where you have to be at $1,939. Connie will explain her situation. and the other thing is I have studies of a friend who's on it. My waiver cost for instance today is monthly and if I was forced into an ICF because getting Social Security retirement OPRS pension and wages, it's undue and wrong to force someone in an ICF or nursing facility against their will unless they need the assistance. So it would cost the state $16,149.83 versus $3,014.27 a month on my case. I hope you know we care that we don't want people forced in an institutional setting because that's really not fair to the individual who worked hard paid into taxes, and number one of all is for this workability, they have to work to be in the program. So that is number one of all. You can't have anyone that doesn't work. So I will let Connie take over with her story.
I don't need a mic. Can you all hear me? I don't know if I can rehearse this one. This is from Bama on. Hello? Is it on? Okay, it is. Okay, thank you. Chair Gross, Vice Chair Barhorst, Ranking Member Baker, and members of the Medicaid Committee, I want to thank you all for the opportunity to provide testimony and support of the House Bill 581. My name is Connie Fraley, and I reside in Warren County, Ohio. I'm a licensed social worker and earlier in my career I worked for eight years as a caseworker with the Ohio Department of Job and Family Services. I am speaking today both as a professional who has worked within the system and as someone who will personally be affected by the issues this legislation addresses. House Bill 581 is a common sense solution that provides flexibility within the current $20,000 income disregard used in the Medicaid buy-in for workers with disabilities program. Importantly, the bill does not increase the existing $20,000 threshold. Instead, it simply allows the district card to be applied to either unearned income or a combination of both, depending on what the individual needs. This flexibility is critically important for people with disabilities who are working but whose financial situations change over time. In my own situation, I will reach full retirement age this May. At that point, my Social Security will convert to retirement benefits, and it will no longer be offset due to OPRS. I would lose eligibility for Medicaid buy-in and would instead face a Medicaid share of costs of approximately $3,263 per month, which represents about 62% of my gross income. Simply put, the level of cost would make it financially impossible for me to remain in the community with the supports that I need. Policies that unintentionally push people with disabilities out of the community living and toward institutional care ultimately cost the state of Ohio more. Many people with disabilities rely on Medicaid, not because they want to, but because Medicare and private insurance do not cover most of the in services that individuals with disabilities need to live safely and independently in their communities When those services are not accessible individuals can be forced into institutional care I also want to acknowledge something openly. Medicaid often carries a stigma, and at times that stigma exists for understandable reasons. During my years working as a caseworker, I saw the system from the inside. However, programs like Medicaid, buying for workers with disabilities, are designed specifically to allow individuals with disabilities to work, contribute, and maintain independence while still accessing the services they need. Helping individuals remain in their homes and communities is also far more cost-effective for the state of Ohio than institutional care. Without this change, individuals who want to remain active and working in their communities may instead be pushed toward institutionalization due to financial barriers. The outcome is not only devastating for individuals and families, but it is also far more costly to the state. as both a licensed social worker and someone personally affected by the issue. I believe House Bill 581 is a practical and physically responsible solution that allows Ohioans with disabilities to remain independent, productive members of their communities. For this reason, I respectfully urge you to support House Bill 581. Thank you.
Any questions? Thank you so much, Mrs. Fraley, Ms. Fraley for your testimony committee. Are there any questions for the witnesses? Yes, Representative
Lett. Thank you, Chairwoman. Thank you, Connie for testifying on this bill. I just wanted to kind of open it up in plain language. Could you just kind of describe the non-choice that you would have to make and what that path would look like for you if this bill was not passed? What would happen to you?
Well, my monthly expenses come to, I'm talking about the bare minimum, come to basically around $3,000. If I had to go on a regular Medicaid waiver, a special income level waiver, then anything over $1,939 has to be paid toward the share cost or premium, so to speak, and that would be $3,263 that I would have to pay per month, which is 62% of my gross. so I couldn't afford to live
follow up
alright committee any other questions for the witnesses thank you so much ladies we really appreciate your time I would like to call up Jan Doherty to provide proponent testimony Jan
okay Okay.
Committee, I would like to direct your attention to the 22 written testimonies that are on your iPads for review. This will conclude the second hearing for House Bill 581. All right. With no other business before this committee, the House Medicaid Committee stands adjourned.