Ohio Health Insurance

 Health insurance in Ohio

● Ohio has a federally subsidized market, so residents HealthCare.gov.

● The open enrollment for 2021 health plans is from 1 November to 15 December 2020. Ohio residents with qualified events can sign up or make changes to their coverage outside of that window.

● Short-term health insurance plans can be sold in Ohio with initial plan terms of up to 364 days.

● Ten insurers offer plans in exchange for 2020 and 2021, the same as in 2019, but up from eight in 2018.

● Ohio Medicaid enrollment grew by nearly 658,000 people under the ACA's Medicaid expansion, with a sharp increase during the COVID pandemic.

● Nearly 197,000 people signed up for the Ohio exchange for 2020, down about 19% from their peak enrollment in 2016.

● The uninsured rate in Ohio has fallen by more than 40% since 2013 (although it was higher in 2018 than in 2017).

● Ohio lawmakers split over support for the ACA.

This page is dedicated to helping consumers quickly find health insurance resources in the state of Ohio. Here you will find information about the many types of health insurance coverage available. You can find the basics of Ohio's health insurance market and the upcoming open enrollment period; a brief overview of Medicaid expansion in Ohio; a quick look at the availability of short-term health insurance in the state; statistics on state-specific Medicare rules; as well as a collection of health insurance resources for Ohio residents.

Ohio's health insurance marketplace

Ohio has a federally subsidized exchange, meaning Ohio residents use HealthCare.gov to enroll in exchange plans. But Ohio is one of seven states participating in plan management and the Qualified Health Plan (QHP) certification process.

The marketplace is a registration platform for individual and family health plans. These plans are used by a wide range of people, including early retirees who are not yet entitled to Medicare, the self-employed, and people employed by small businesses that do not offer health benefits.

Open the enrollment period and dates

Open enrollment in Ohio for individual market coverage 2021 (on- and off-exchange) runs from November 1, 2020 to December 15, 2020. This window is an opportunity for people to renew existing coverage (and update their income information with the exchange, if anything has changed in the last year) or switch to a different plan for next year. It's also an opportunity for people to sign up for individual market coverage recently, with coverage having effect in January. Pre-existing conditions and preventive coverage are not taken into account when people apply for health insurance policies, so these are no longer obstacles for individual market applicants.

Outside of the open enrollment window, Ohio residents must have a qualifying event in order to purchase regular primary medical coverage, either through exchange or directly from a health insurance company.

During open enrollment for 2020 coverage, 196,806 Ohioans enrolled in individual market plans through the state exchange, down about 19 percent from 2016, when nearly 244,000 people signed up. In most states that use HealthCare.gov, enrollment peaked in 2016 and has declined since then.

The decrease in enrollment is due to a number of factors, including increasing premiums for people who are not eligible for premium subsidies, confusion over the legal status of the ACA (due to GOP efforts to repeal the law through legislation and court cases), expanding short-term plans, and eliminating the individual mandate sanction at the end of 2018.

Insurance companies in Ohio health insurance marketplace

By 2021, all ten Ohio market insurers will continue to offer coverage, and some are expanding their coverage areas.

As of 2020, nearly all residents of the state could choose between at least two insurers in the exchange. By 2021, everyone can choose between at least two insurers and residents in 78 of the state's 88 counties can choose from three insurers.

This is in stark contrast to 2018, when residents of 42 Ohio counties had only one insurer available. This dropped to 16 counties in 2019, and thanks to coverage area expansions, Logan County was the only area in the state where only one insurer offers exchange plans for 2020. For 2021, each area of the state has at least two participating insurers on the market.

Insurers offering plans in the Ohio exchange for 2021 include:

AultCare

Ambetter (Buckeye Community Health Plan)

CareSource (CareSource service area expanded in 2020 to include 65 counties)

Community Insurance Company (Anthem BCBS) (returned to the stock exchange at the age of 29, after being released at the end of 2017)

Medical Health Insuring Corp. of Ohio (Medical Mutual) 

Molina (service area expanded to a total of 40 counties in 2021)

Oscar Buckeye State Insurance 

Corporation (available in Columbus metropolitan areas)

Oscar Insurance Corporation of Ohio (available in Cleveland metropolitan area)

Paramount

Summa

All ten insurers will continue to participate in the exchange in 2021. According to the Ohio Department of Insurance, the proposed overall rate change is a decrease of 0.4%. These rates have been mainly targeted as proposed, although our calculations indicate an overall average rate increase of 3.3% for 2021.

Medicaid expansion in Ohio

Ohio's acceptance of federal funding to expand Medicaid eligibility to 138 percent of poverty played a significant role in the state's success with Obamacare.

Between 2013 and July 2018, the state saw an increase of nearly 600,000 people covered by Medicaid and CHIP. By the end of 2019, however, the net increase in Medicaid/CHIP enrollment in Ohio had fallen to less than half a million people. (In most states, Medicaid enrollment grew sharply for about two years after the expansion was implemented, and then stabilized; in some cases, it has declined since then due to changes in the way a state verifies eligibility, improving economic conditions in the state, etc.)

But by June 2020, net enrollment growth in Ohio's Medicaid/CHIP coverage had jumped to nearly 658,000 people. Nationally, there has been a sharp increase in Medicaid enrollment during the COVID pandemic, as the loss of jobs and income makes people barely eligible for coverage.

Short-term health insurance in Ohio

The Trump administration loosened federal rules for short-term plans in 2018, allowing them to have much longer durations, including extensive renewals. But the new rules are clear in their minds that states can impose stricter guidelines. Ohio allows short-term health insurance plans to have terms of up to 364 days, but renewals are prohibited.

How did Obamacare help buckeye state?

Under the ACA, Ohio's federally subsidized exchange and expansion of the Medicaid program helped both residents gain health coverage. During the first open enrollment period, an equal number of people enrolled in private plans and Medicaid.

The state's uninsured rate has dropped significantly due to the ACA, largely due to the state's expansion of Medicaid. According to U.S. Census data, Ohio's uninsured rate stood at 6.5% in 2018, down from 11% in 2013. It had been even lower in 2017, but there was a nationwide increase in the uninsured rate under the Trump administration.

As of December 2020, there were more than 183,000 Ohio residents enrolled in health coverage through the market. They all have coverage for the ACA's essential health benefits, without having to worry about things like pre-exist condition exclusions or lifetime/annual benefit limits. More than three-quarters of enrollees receive premium grants that make their monthly premiums much cheaper than they would be without the ACA. And a third are receiving cost-sharing reductions, which make out-of-pocket medical expenses (deductible, coinsurance, copays) more affordable.

Ohio and the Affordable Care Act

U.S. senators from Ohio are divided on health care reform. Sherrod Brown, a Democrat, supports the ACA, while Rob Portman, a Republican, is a vocal opponent of the ACA.

In the House, Ohio delegates now include 12 Republicans and only four Democrats. Only one of those Republicans - David Joyce, who won re-election in 2018 - voted against the GOP's American Health Care Act, which was an effort to repeal the ACA.

Ohio's state legislature has a strong Republican majority, and former Governor John Kasich, also a Republican, was not a fan of the ACA in general. (He did not see it as effective in reducing

health care costs and said it was "ruining the economy." So it's no surprise that Ohio has opted for a federally subsidized exchange rather than managing its own exchange.

But Kasich broke ranks with most of his fellow Republican governors - and his state legislature - in opting to expand Medicaid in Ohio. His reasoning was that it would be immoral not to do so, and he vehemently challenged Republicans on this issue. Ohio's average monthly Medicaid enrollment has grown by nearly half a million people since 2013. That's a 23 percent increase, far exceeding Medicaid growth in most states with Republican governors (the national average in all states, including those with Democratic leadership, was 26 percent).

Kasich was also vocal in his opposition to congressional Republicans' proposals to completely repeal the ACA, including Medicaid expansion. Kasich met with President Trump and then-HHS Secretary Tom Price in 2017 to address his concerns and discuss possible reforms of the current system. Kasich was limited to the deadline and could not seek re-election in 2018. Republican Mike DeWine won the governor's race and ran in January 2019. DeWine has long opposed the ACA, but his stance on Medicaid expansion seemed to soften to from 2018, when he said the state would keep the Medicaid expansion in place if he became governor. DeWine has been attorney general of the state since 2011. And while he joined a lawsuit that year that challenged the constitutionality of the ACA, he did not part with Texas V. Azar case (now California v. Texas), where 18 GOP-led states are trying to topple the ACA.

Medicare enrollment and coverage in Ohio

As of September 2020, there were 2,382,039 Ohio residents enrolled in Medicare. Most are eligible for Medicare because of age, but about 16% are under the age of 65 and are eligible for Medicare because of a disability.

Ohio Health Insurance Resources

● Ohio Department of Insurance - Regulates, supervises and licenses health insurance companies, brokers, and agents.

● Ohio Senior Health Insurance Information Program - Advice, education and assistance for Medicare beneficiaries and their caregivers.

● Medicare Rights Center - a national program that can provide assistance with Medicare-related applications.

● HRS Erase — The federally funded Navigator organization in Ohio; can provide information and assistance with market enrollment, including enrollment in Ohio's Medicaid program.

● CAP4Kids, Columbus area (Children's Advocacy Project) — A collection of community resources aimed at improving children's health.