The Ohio Council Welcomes New Provider Member, Transitions Behavioral Health

Transitions Behavioral Health in Cincinnati, OH. Amy Bailey, CEO can be reached at [email protected] or by phone at (513) 832-2884. Transitions Behavioral Health provides Behavioral Health Services, Early Intervention, Community Support, Case Management, and Adult Day Treatment in Hamilton, Clermont, Butler, Warren and Montgomery counties. Click here to learn more about Transitions Behavioral Health!

Trump Administration Sued Over Medicaid Changes

Half of states are suing over new Medicaid eligibility requirements that advocates have warned will lead people with disabilities to lose coverage.

A coalition of officials from 25 states and Washington, D.C. filed a lawsuit last week challenging recently released rules for Medicaid work requirements.

Under the mandate, which most states must implement by the beginning of next year, many beneficiaries will need to prove that they are working, volunteering or going to school at least 80 hours per month in order to retain coverage.

In the lawsuit filed against CMS and the U.S. Department of Health and Human Services, the states allege that the Trump administration’s interim final rule is more restrictive than Congress intended.

Moreover, advocates fear that even those who should be untouched by work mandates could be unintentionally impacted by new paperwork requirements.

New 50-State Data Shows Steep Drops in Affordable Care Act Enrollment

States across the country saw steep drops in the number of people covered by the Affordable Care Act over the past year, with Ohio and Oklahoma each losing nearly one-third of enrollees, according to new federal data that provides the first complete 50-state breakdown of sharp enrollment declines following the January expiration of enhanced subsidies. The data, posted in late June by the Trump administration and first reported on by The Associated Press, reveals how changes in each state’s insured population led to around 2.6 million fewer Americans having Obamacare plans in February compared with the same time last year.

Ohio Children Unable to Access Mental Healthcare Because of Insurance, Costs, and Lack of Providers

Costs, provider availability, and health insurance limitations were the top reasons Ohio children were not able to access mental healthcare, according to a recent study from the Health Policy Institute of Ohio.

Nearly half said unaccepted health insurance was the reason their child did not receive mental healthcare treatment while 40% said provider availability and 29% said cost (people surveyed could select more than one barrier).

Just under half of Ohio children were on Medicaid and 46% had commercial insurance in 2023. Health Policy Institute of Ohio found commercial plans rarely cover therapeutic behavioral health support, case management, intensive home-based treatment, behavioral health nursing, crisis services/mobile response, and peer recovery services. “One of the most important takeaways from this brief is unlike traditional physical health care, it tends to be that insurance problems are more substantial for kids who are on commercial insurance compared to a program like Medicaid,” said Health Policy Institute of Ohio Analyst Brian O’Rourke. The state has a lack of mental health providers and 75 Ohio counties are mental health shortage areas, according to a study last year from the Health Policy Institute of Ohio.

Ohio behavioral health clinicians are reimbursed an average of 18% less than medical or surgical clinicians, which can “lead some providers to not accept insurance and instead require patients to self-pay, which is out of reach for many families,” according to the study.

Sometimes having a health insurance plan is not always enough.