COLUMBUS, Ohio – State leaders in Ohio are making a push for Medicaid work requirements, but some researchers are cautioning that could turn back the clock on progress made to improve health-care access.
About 3 million Ohioans are insured through Medicaid, including more than 700,000 who were added during the 2016 expansion. According to a report by Loren Anthes, public policy fellow in the Medicaid Policy Center at the Center for Community Solutions, more than six in ten Medicaid enrollees in Ohio already work full- or part-time.
"The Legislature has a concept that a lot of the folks who are part of the Medicaid expansion are just siphoning benefits, but that couldn't be further from the truth," Anthes insisted. "In fact, most folks are on it for less than a year, and most of the expense of the program lies with the disabled and the elderly, not with the Medicaid-expansion enrollees."
The Centers for Medicare and Medicaid Services issued guidance in January asserting that work requirements can improve health and well-being, and help families gain economic stability.
Anthes counters that evidence from other safety-net programs shows that isn't the case, and said many Medicaid enrollees could lose coverage because they may not be able to meet the requirements, due to job or family commitments.
Medicaid work-requirement waivers were recently approved for Indiana and Kentucky, and have been requested by several other states. But Anthes noted there are questions about the legality of the waivers.
"In states where you've seen this move forward, there have already been lawsuits put out there," he said. "And I imagine that will be much the same here in Ohio, with a lot of this potentially tied up in courts and many folks concerned that this is a violation of the Social Security Act."
He cited economic concerns as well. Health care is the second-largest industry in Ohio, behind agriculture. He explained if too many people lose coverage, some medical facilities, particularly in rural areas, may need to close their doors.
"To suddenly remove these resources not only dis-benefits this huge area of employment and this huge area of economic impact for providers and others, it would have drastic impacts on things like the opioid epidemic, on chronic-disease management," Anthes said.
The American Medical Association and the American Academy of Pediatrics are among physicians' groups opposing work requirements, claiming they create barriers to getting health care.
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A new report brands Connecticut's tax system as "regressive" for low- to middle-income residents and uses a report from the state to make its point.
The Connecticut Voices for Children report reviewed the state's Tax Incidence Study, in which one of the biggest findings is how property taxes contribute to a regressive system. Because a town's mill rate does not adjust based on a tax filer's income, low- to middle-income residents spend more on housing as a percentage of their budget than those with higher incomes.
Patrick O'Brien, research and policy director of Connecticut Voices for Children and the report's author, pointed out Connecticut could have a more fair tax system by implementing a few policy changes.
"One, eliminate and/or close the state's tax gap, which was shown likely primarily benefits high-income and wealthy tax filers. Two, eliminate and/or reduce regressive tax expenditures. And three, possibly increase personal income tax rates on high-income and wealthy tax filers," O'Brien outlined.
He argued the new revenue could then be used to provide tax cuts for lower and middle-income households, and could help with creating a state-level child tax credit. One thing to note is the state's report was based on data from 2020.
O'Brien acknowledged the state has made changes to its tax system since then but the Connecticut Voices for Children report showed despite the new cuts, the tax system is still regressive.
The report detailed the effects of the state tax system beyond its residents. Connecticut has only recently come in second behind Massachusetts for income inequality.
O'Brien emphasized it is only exacerbated by the regressive tax system.
"This is really hurting the economic well-being of the state's low- and middle-income tax filers, and that, in turn, ultimately ends up hurting economic growth in the state as well," O'Brien contended. "It can have multiple effects that we're trying to address."
The report recommended creating a task force to ensure all future reports from the Department of Revenue Services have all the required information to get a thorough picture of the state tax system. The most recent report faced criticism for lacking some data.
Disclosure: Connecticut Voices for Children contributes to our fund for reporting on Budget Policy & Priorities, Children's Issues, Education, and Juvenile Justice. If you would like to help support news in the public interest,
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While three initiatives received the go-ahead to appear on Washington's November ballot at the end the legislative session last week, three that have already been approved could also have a big impact on the state.
These measures could have an especially big effect on funding in the state. Executive director of Fuse Washington, Aaron Ostrom, said they also have a few more things in common.
"They're all funded by the same Republican mega donor, Brian Heywood, and all sponsored by the MAGA Republican Party Chair Jim Walsh," said Ostrom. "The second thing about them is that all three are deliberately deceptive and misleading. And then the third thing about these three is they all seek to cut billions of dollars in funding for critical public priorities."
The initiatives would repeal the state's capital gains tax, undo the Climate Commitment Act, and would make optional the WA Cares program - which helps people save for long-term care.
Heywood says he's backing these measures because no one in the state is challenging Democrats on taxes and other policies.
Ostrom said the initiative that would repeal the capital gains tax for profits of more than $250,000 - which fewer than 4,000 people paid last year - would leave a big hole in the state's budget, costing nearly $900 million a year.
"Initiative 2109 would repeal the capital gains tax," said Ostrom, "which would take billions of dollars in funding from child care and schools to give a tax cut to Washington's wealthiest."
Supporters of I-2109 say it is essentially an income tax, which is barred in the Washington state constitution. However, the state Supreme Court upheld the tax as constitutional in a ruling last year.
Ostrom said he believes all three initiatives are a threat to the state.
"These three initiatives would devastate funding for our kids and schools," said Ostrom. "They would dismantle our protections against air and water pollution, and they repeal efforts to care for our seniors."
Disclosure: Fuse Washington contributes to our fund for reporting on Climate Change/Air Quality, Health Issues, Human Rights/Racial Justice, Social Justice. If you would like to help support news in the public interest,
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Virginia child advocates are calling on state lawmakers to improve school funding.
The concern grew when several bills focused on building up school mental health failed in their respective General Assembly committees. The state is ranked 48th for youth mental health by Mental Health America.
Cat Atkinson, mental health policy analyst at Voices for Virginia's Children, said given the ongoing youth mental health crisis, now is the time for action.
"Having mental health professionals in our schools creates a space where, one, our young people are able to be where they're comfortable," Atkinson recommended. "They have built relationships with staff and are able to be in their schools, and to be able to have their needs met in a place where they are consistently."
The mental health staff funding bills failed or were continued to the 2025 session due to high costs. Combined, the bills would have called for around $120 million to be spent in the 2025 and 2026 budgets.
Beyond money, a long-term workforce shortage is depriving schools of having proper mental health staff. A KFF report found 48% of schools nationally have insufficient access to licensed mental health professionals.
The funding inconsistencies affect more than just mental-health services. A 2023 report found not only are school divisions getting less funding than most other states, but Virginia is still using the Great Recession as a benchmark for cost-reduction measures.
Atkinson pointed out a lack of funding affects not just schools.
"The trickle-down effect of our state underfunding public schools places a burden on the local communities," Atkinson argued. "Which leaves the quality of our young people's education to depend entirely on the neighborhoods they reside in."
She added the current situation is not equitable because community resources across regions vary significantly, but noted there are other ways to get mental health care in schools.
In 2023, the General Assembly passed Senate Bill 1300, which requires teachers to get trauma-informed care training every three years. Gov. Glenn Youngkin's Right Help, Right Now plan would also bolster school and community mental health needs.
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