Ohio At A Cross Roads: Medicaid Expansion
The Ohio General Assembly and Governor Kasich are at odds over Medicaid expansion as anticipated by the Affordable Care Act.
The Governor, a conservative Republican, included a Medicaid expansion in the state budget for all Ohioans with incomes up to 138% of the federal poverty level. This is the right thing to do for Ohioans who are now uninsured and cannot obtain the care they need to become, or remain, healthy. It is also the right thing to do to help Ohioans become more employable so they can be self-sufficient and stable. It is also the right thing to do for the state’s economy and budget.
Expanding access to health care to address the needs of the uninsured and to help Ohioans become self-sufficient and stable is important, but the last point about the state’s economy and budget is why every member of the Ohio General Assembly should support the Medicaid expansion.
The Medicaid expansion draws federal dollars into Ohio. The Governor projects that $13 billion dollars of federal funding would come to Ohio by 2020. Other projections are as high as $20 billion. In any case, a huge amount of money would circulate and generate additional economic growth in Ohio’s towns, cities and counties.
The Medicaid expansion fills a $400 million hole in the state budget because it off sets costs for mental health, corrections, drug and alcohol treatment and other services.
Read more about the impact of a Medicaid expansion in Ohio, on the Office of Health Transformation’s website, http://www.healthtransformation.ohio.gov/LinkClick.aspx?fileticket=vDu4XgXYGm0%3d&tabid=136
The expansion has the overwhelming support of the public, stakeholders and others. Click here to see what stakeholders and editorial boards have said about the expansion.
What they are saying about extending Medicaid coverage: Stakeholders and Editorials
The House removed the expansion from the budget it passed and has said that it will consider an expansion in the fall of 2013. The Senate President has announced that he would support a separate bill to explore whether to expand Medicaid, but it is unclear when such a bill might be introduced, how quickly it would move, and whether the Senate would make it a priority.
In the meantime, the clock ticks on and Ohioans may not get the care they need and deserve, and the state will lose billions of dollars of federal funding, just when the state needs to increase its economic activity and growth. Standing in the way of expanding Medicaid is bad for the state and bad for Ohioans.
The Governor is right. Ohio needs to expand Medicaid now to provide care for its residents and to strengthen our economy. As concerned Ohioans, we should all first, contact the Governor to thank him for fighting for Medicaid, second, contact our legislators to ask them to do what is right for Ohio and Ohioans, expand our Medicaid program now and, third, tell our friends and neighbors to do the same.
The Medicaid expansion currently being debated in the state budget would improve the health, safety and stability of Ohioans and Ohio families.
People who have access to health care are healthier. They get more appropriate preventive care and avoid emergency-room visits and heath crises. Many low-wage workers do not have access to employment-based health insurance, and they cannot afford to buy private insurance.
Families and individuals with access to health care are safer. They can get the health care they need, including immunizations and prescription medications, to avoid health risks and address chronic conditions.
Families and individuals with access to health care are more stable. Medical debt was a factor in 62 percent of the 38,000 bankruptcy filings in Ohio in 2012. Medical debts also play a significant role in home foreclosures. Access to health care would significantly reduce the number of bankruptcies and home foreclosures so that more Ohioans could remain economically stable and independent.
Debt also is a factor in domestic violence. Reducing medical debt would lessen family stress and domestic violence, keeping more families intact and stable.
Access to health care also will make Ohioans more employable, increasing their financial and social stability.
The Medicaid expansion would provide a helping hand to Ohio, Ohioans and Ohio families. It would keep Ohioans healthy, safe and stable. It is the right decision for Ohio and all of our residents.
- EUGENE R. KING
Ohio Poverty Law Center
Testimony to Joint Senate School Safety Subcommittee: Creating a Positive School Climate and Eliminating Harsh Zero Tolerance Policies Improve School Safety
The following is written testimony submitted by Ohio Poverty Law Center staff attorney Sarah Biehl at the Joint Senate School Safety Committee hearing at the Ohio Statehouse on March 12, 2013:
Senator LaRose, Senator Lehner, members of the School Safety Subcommittee, thank you for the opportunity to testify today on the subject of school safety. This is a vitally important topic for Ohio’s youth, and I commend you for taking the time to seek public input on how the legislature might best address it and protect children’s right to receive their educations in safe, secure, positive environments.
My interest in this topic stems from my experiences researching, analyzing, and advocating on school discipline issues, including zero tolerance policies, the overuse of harsh exclusionary discipline such as suspension and expulsion, and the negative outcomes for students that come with increased police presence in many schools. I am here today to urge the committee to focus on taking action that will help Ohio schools work with their communities to build positive school climates where students, teachers, and staff feel safe, protected, and respected. Evidence is growing across the United States that the best way to do this is to dismantle the school to prison pipeline: eliminate zero tolerance policies, reduce the use of harsh exclusionary discipline to address minor, non-violent misbehavior among students, and put in place systems that build trust, respect, and dignity among all members of a school community.
In November 2012, the Ohio Poverty Law Center and Children’s Defense Fund-Ohio jointly published an issue brief entitled “Zero Tolerance and Exclusionary School Discipline Policies Harm Students and Contribute to the Cradle to Prison Pipeline.” In the brief, we drew on Ohio Department of Education data to show how Ohio children are being suspended or expelled from school at alarming rates, mostly for non-violent behavior such as “disobedient or disruptive behavior.” Moreover, Ohio’s most vulnerable students disproportionately bear the burden of such policies. African American students statewide are over five times more likely to be suspended for engaging in the same behavior as white students. Children with disabilities are anywhere from two to eight times more likely to be suspended as non-disabled children. Low-income children are two and a half times more likely to be suspended as children who are not low-income.
These disparities and the overall trend toward excluding children from school as a form of discipline make our schools less safe because these practices foster negative school climates in which children feel criminalized and isolated from what is, for many, one of the few stable institutions in their lives. The consequences to schools, children, and communities are devastating. Research nationally shows that schools that use zero tolerance policies and have higher suspension rates are not safer – in fact, the increase in the use of harsh zero tolerance policies correlates with an increase in violent incidents on school property, and also correlates with lower academic achievement and test scores. For children, a history of prior suspensions from school is the number one factor that leads to kids dropping out of school and is linked with a host of other negative academic and life outcomes. And communities where a large number of young people are neither in school nor working are not as productive or stable as communities with higher high school graduation and employment rates. When our schools and communities are less safe and stable, our students and school staff are, too.
Since 2004, I have coordinated and worked with the Dignity in Schools Campaign (DSC), a national multi-stakeholder coalition of youth, parents, educators, grassroots groups, and policy and legal advocacy groups that works to challenge the systemic problem of school pushout in our nation’s schools. One of the goals of the DSC is to ensure that those most affected by the education system and school pushout are at the center of our work and have a voice in policies that will affect their lives. Since the Newtown shootings last year, a group of youth leaders within DSC have been working on an effort to ensure that their voices are heard by the policymakers around the country who are considering new policies in response to Newtown. Since none of those students are here today, I wanted to share a small excerpt of their statement with you:
We can imagine the pain and suffering that the youth and families in Newtown, Connecticut are experiencing. As youth growing up on some of America’s deadliest streets, we are all too familiar with gun violence and its impacts. Too many of us have been shot and shot at. We have buried our friends and family members. Nearly all of us have been to more funerals than graduations. No one wants the violence to stop more than we do. . . .For forty years, federal, state, and local dollars have gone toward the massive build-up of juvenile halls, jails and prisons while simultaneously severe cuts have been made to our school and higher education budgets. . . .As a result, in communities of color throughout the nation, students now experience a vicious school-to-jail track. These policies haven’t protected us, helped us to graduate or taught us anything about preventing violence. They have taught us to fear a badge, to hate school and to give up on our education. We understand too well that guns in anyone’s hands are not the solution. You can’t build peace with a piece.
Obviously, these students represent a particularly urban perspective, and are approaching this issue specifically as youth of color, and you as policymakers have to make policies that apply to all school districts in Ohio, urban, rural, and suburban, but I think their perspective is uniquely compelling. Their full statement goes on to make many of the same recommendations I make to you here today.
Instead of continuing harsh school discipline policies and placing more guns and/or police officers in schools, I urge you to consider policies that will build positive school climates instead:
- Eliminate zero tolerance policies. Ohio has a state statute, R.C. 3313.534, that directs Ohio boards of education to adopt “a policy of zero tolerance for violent, disruptive, or inappropriate behavior.” This state statute is outdated, ineffective, and should be eliminated and replaced with a revised code section specifically encouraging school districts to adopt positive, preventive approaches to school discipline and bullying.
- Develop, promote, and fund trainings and other resources for teachers, administrators, and other education professionals on classroom behavior management, school-wide positive behavior interventions and supports, restorative practices and restorative justice programs, and other proven, evidence-based models for teaching children positive behavior.
- Create opportunities for parents and students to be involved in implementing and monitoring new school discipline policies that promote positive school culture.
- Address bullying in schools by providing incentives for school to put in place preventive bullying programs and by adding an enumerated list of categories of students to be protected from bullying. Enumerated policies have been shown nationally to be more effective at increasing student safety and improving the efficacy of anti-bullying strategies.
There is a lot more information and data, both locally and nationally, on these topics and I would be happy to share details with any of you who have more questions or would like to talk in further detail. I hope that I have helped to provide a slightly different perspective on how this committee can best work to increase safety and security in Ohio’s schools, and I hope fervently that regardless of what this committee does, it maintains its focus on ensuring that all Ohio children have access to safe, high quality educations and are treated with dignity and fairness in school.
 Statement By Youth of Color On School Safety and Gun Violence In America in the Aftermath of the Mass Shooting at Sandy Hook Elementary School, http://www.dignityinschools.org/sites/default/files/Youth_Statement_Gun_Violence.pdf
Robo-signer: Sounds like a boring sci-fi movie that’s light on action. In reality, it’s a back-office system of quickly signing off on foreclosure documents like affidavits without actually doing what the affidavits say was done. Also known as cheating and lying. Tampa Bay Times, Dec. 26, 2010
Robo-signing, as a common practice in the financial sector, has been on my mind most recently because of the December 4, 2012 announcement by Cash America (doing business in Ohio as Cashland) that it will refund millions of dollars to about 14,000 Ohio borrowers taken to court by the lender to collect on defaulted loans. To quote the Fort Worth Star-Telegram: “The company, which also makes so-called payday loans, said it recently learned that some employees ‘did not prepare some court documents properly in many of its Ohio collections legal proceedings.’ ”
We can translate this to mean employees were robo-signing documents submitted in court cases to prove Cashland’s cases against borrowers (see above – a.k.a. cheating and lying). Cash America, a payday lender and pawn broker, is the latest lending business to admit to irregularities in the production of documents necessary to prove its claims in court against borrowers. The first industry, of course, was mortgage servicing.
The second financial industry to have fraudulent practices exposed was the debt buying industry. Midland Finance, one of the largest debt buyers in the country, was sued in 2008 for filing false affidavits. In discovery, it came to light that “specialists” in the litigation support department of Midland would sign between 200 and 400 computer generated affidavits per day. Midland was also sued by and settled with the Minnesota Attorney General in mid-2012. The settlement contains a number of provisions, but to address robo-signing, Midland must not file affidavits with the court unless the person has: a) read and understood them, b) confirmed the authenticity of any documents filed with the affidavit, c) only based the affidavit on the signer’s personal knowledge, and d) signed the affidavit in the presence of a notary who acknowledges the affiant’s signature in accordance with law. These criteria are almost identical to some standards agreed to by the five major servicers in the national mortgage settlement. These sound a lot like promising to follow the law that already applies.
Cashland calls the problems that led to its voluntary loan refund program “technical errors”. This is the same argument made by mortgage lenders and debt collectors. Paperwork problems are technical errors that do not change the bottom line – the homeowner/consumer borrowed the money, or used the credit card, and defaulted. They owe the money to someone.
Let’s think about that. Our legal system is an adversarial one, requiring each party to prove its claims or defenses using evidence that meets standards of reliability, dependability, and truthfulness established by the Rules of Court and the Rules of Evidence. Endorsing results over process erodes the fundamental fairness of the system that depends on all parties being held to the same standards.
In Cash America’s case, the problems occurred repeatedly over the course of five years. This is not technical error – this is evidence of a standard business practice – a practice that reflects a disregard for integrity of the legal system.
Cash America estimates the voluntary loan refund program will cost $13.4 million. To put this in perspective, Cash America reported $135,963,000 in net profits in 2011; in the second quarter of 2012, the company reported net income of $29,820,000, and revenues of $411.6 million.
This piece was written by OPLC Staff Attorney Joe Maskovyak.
The legislature has adjourned for the 2011-12 term, and opponents of SB 271, including OPLC, can breathe a little easier knowing that SB 271 died a quiet death when this legislature adjourned for the final time. The breathing will only be a little easier, since the powerful telecommunications (telecom) lobby is certain to find a champion to reintroduce SB 271 – the latest telecom deregulation bill – soon after the new legislature convenes in January.
SB 271 was the latest in a series of telecom dereg bills, designed to grant increasing freedom to to the phone companies, all of which have been written and supported by the industry, ostensibly to promote “progress and investment” in Ohio. Of course, as is often the case, the guise of “progress” comes with a price. SB 271 essentially would allow the market (assuming there is one) to regulate the price of landline telephone service, and the Public Utilities Commission of Ohio (PUCO) would not be able to establish any price caps on the cost of your phone rates. Along with the end to price caps to protect consumers who could be gouged by unlimited rate increases, consumers would also see the elimination of what few consumer protections remain in the PUCO rules. Minimal protections, such as getting a phone installed within five days from the date you order and pay for services, or having the phone company reimburse you for outages if they take more than three days to repair them, would have gone away. These are examples of regulations which phone companies apparently find too onerous and burdensome in conducting business.
SB 271 would have paved the way for landline operators to get out of the business of maintaining their existing lines. This could lead to a host of problems. Phone companies only had to show there was some competition but not necessarily competition to all communities. Consequently, it is quite possible, especially in rural southeast Ohio, that a landline provider could withdraw from an area where cell phone coverage is spotty or nonexistent. If your cable provider uses that same landline to transmit its signal, and the landline telephone provider leaves, you can also say good bye to your cable. Alternatively, if you have cell phone coverage but no cell phone, you may be forced to buy one, even if you cannot afford to pay the cost for a new cellphone or for service, if you want to stay connected.
Finally, SB 271 would have signaled the end of Basic Local Exchange Service (BLES). This is a no frills service that allows unlimited calling for a small flat rate for those who do not want or need more service. Together with the end of BLES, “Lifeline” service, which allows affordable phone service for the very poor, could also have gone extinct. This is because Lifeline is priced as a discount from BLES service. How can one discount from something that no longer exists?
The extra time granted by the death of SB 271 should allow more time to better study a radical proposal that was rushed through the Senate and seemed to be gaining momentum before this legislative session ended. OPLC believes there should be more time to study what would be a transformation of the telecom landscape. In fact, the last telecom bill we saw in the legislature, SB 162, which passed in late 2010, statutorily created a study committee to report on that bill’s deregulation impacts. A report is not due until 2014. Sadly, the study committee has never been convened, much less begun to discharge its reporting duty. Hopefully, there will be time for this committee to meet and report about the impacts of the last round of deregulation before we make decisions on further telephone deregulation in the next legislative session.
In the interim, however, we need stand vigilant to the reintroduction of a new telecom dereg bill similar to SB 271, which we at OPLC fully expect to occur when the legislature reconvenes in January 2013. We need to tell our legislators to tread slowly and carefully and to refuse to pass a new bill without full examining all of the possible consequences. Consequently, we need to push our legislators to convene the SB 162 Study Committee to examine what has occurred thus far in the industry (which was the intent of the statutory creation of the committee when the last telecom bill was passed) before we take away consumers’ lifelines and/or landlines. OPLC will be monitoring these issues in the next legislative session, and will report back with details about any new developments.
Check out OPLC’s talking points on SB 271 here. Contact Joe Maskovyak at firstname.lastname@example.org or Mike Smalz at email@example.com if you’d like more information about this or any other telecommunications deregulation issues.
House Bill 561 (HB 561)—sponsored by Representative Lynn Slaby—was introduced last May and has been assigned to the House Judiciary and Ethics Committee. It is on a “fast track” and will likely be passed by the Ohio General Assembly before the end of this year.
The Ohio Child Support Directors Association (OCDA) drafted and is pushing for quick passage of HB 561 in order to address inconsistencies in current child support laws and to bring Ohio into full compliance with federal IV-D rules governing expedited administrative processes and applications for IV-D child support enforcement services. There are significant changes regarding the timeframes for appealing certain CSEA actions or recommendations, the scope of the state income tax intercept mechanism, the requirements for discharging an existing lien on a defaulting obligor’s property, the effective date on an administrative child support order, and the effective date of initial administrative child support orders. The bill is also likely to be amended to include language drafted by Mike Smalz of the Ohio Poverty Law Center (OPLC) giving courts and child support enforcement agencies (CSEAs) jurisdiction and authority to lower arrearage-only payments and income withholding after the termination of the current child support order. This article summarizes the major proposed changes.
1) Reduces from thirty to fourteen days after the issuance of a CSEA administrative order, decision or notice or receipt of notice the time period for:
- objecting to an administrative order determining parentage, objecting to an administrative support order by bringing an action for the payment of support and provision for a child’s health care;
- requesting a hearing on modification of child support by a CSEA;
- requesting an administrative hearing following a CSEA investigation of a reason to terminate child support; and
- moving for a judicial determination of a CSEA decision following investigation of a reason to terminate child support.
2) Increases from seven to fourteen days the time period for an obligor to request a mistake of fact hearing or a subsequent court hearing regarding a CSEA default determination or a CSEA determination regarding the availability of private health insurance at a reasonable cost.
3) Expands the State income tax intercept mechanism to include collection of overdue spousal support.
Current law allows CSEAs to work with the Tax Commissioner to collect overdue child support; the law will allow CSEAs to recover any overdue support, not just child support, through a state income tax intercept so long as the case is a IV-D case. (This change will affect cases involving both child support and spousal support orders, but should not affect spousal support-only cases.)
4) Eliminates the automatic requirement that CSEAs discharge a lien against a delinquent support obligor upon the issuance of a new income withholding or a deduction notice or a new support order.
CSEAs would have discretion to decide whether or not to file a notice requesting that the county recorder discharge the lien on an obligor’s real or personal property in cases where a new income withholding notice or support order has been issued to collect accrued arrears.
5) When the CSEA issues an initial administrative child support order, the order will become effective on the date of the administrative hearing.
Therefore, if the obligor or obligee appeals the administrative child support order to the juvenile court and the administrative order is upheld, the order will be in effect retroactive to the date of the CSEA’s administrative hearing.
6) Gives the court discretion to reduce arrearage-only payments and income withholding below the amount ordered to be paid and withheld to pay both current child and arrears under the child support order that was in effect during the child’s minority.
This change should benefit low income obligors who experience a drastic decline in income sometime after the termination of their current child support obligation and before the liquidation of the entire arrearage. For example, if the child turns 18, thereby terminating the current child support obligation, and the obligor later becomes disabled and his only income is SSD benefits, he could ask the court or CSEA to lower his arrearage-only payments because of his drastically changes circumstances. By contrast, under current law the obligor would be required to continue to pay the same amount, regardless of any change in circumstances or personal hardship, until the entire arrearage was paid off.
The ODJFS Child Support Guidelines Council voted to recommend the last change as an amendment to HB 561. Although that provision is not currently in the bill, the OCDA plans to incorporate that amendment into HB 561 before it is passed by the General Assembly during the lame duck session. The proposed language is:
3121.36 Authority to collect arrearage after termination of order.
The termination of a court support order or administrative child support order does not abate the power of any court or child support enforcement agency to collect any overdue and unpaid support or arrearage owed under the terminated support order or the power of the court to punish any person for a failure to comply with, or to pay any support as ordered in, the terminated support order. The termination does not abate the authority of the court or agency to issue any notice described in section 3121.03 of the Revised Code or to issue any applicable order as described in division (C) or (D) of 3121.03 of the Revised Code to collect any overdue and unpaid support or arrearage owed under the terminated support order. If a notice is issued pursuant to 3121.03 of the Revised Code to collect the overdue and unpaid support or arrearage, the amount withheld or deducted from the obligor’s personal earnings, income, or accounts shall be REBUTTABLY PRESUMED TO BE at least equal to the amount that was withheld or deducted under the terminated child support order. A COURT OR CHILD SUPPORT ADMINISTRATIVE AGENCY ADMINISTERING THE CHILD SUPPORT ORDER MAY CONSIDER EVIDENCE OF HOUSEHOLD EXPENDITUTES, INCOME VARIABLES, EXTRAORDINARY HEALTH CARE ISSUES, AND OTHER REASONS FOR DEVIATION FROM THE PRESUMED AMOUNT.
Effective Date: 03-22-2001
3123.14 Collecting arrearage where order is terminated.
If a child support order is terminated for any reason, the obligor under the child support order is or was at any time in default under the support order and, after the termination of the order, the obligor owes an arrearage under the order, the obligee may make application to the child support enforcement agency that administered the child support order prior to its termination or had authority to administer the child support order to maintain any action or proceeding on behalf of the obligee to obtain a judgment, execution of a judgment through any available procedure, an order, or other relief. If a withholding or deduction notice is issued pursuant to section 3121.03 of the Revised Code to collect an arrearage, the amount withheld or deducted from the obligor’s personal earnings, income, or accounts shall be REBUTTABLY PRESUMED TO BE at least equal to the amount that was withheld or deducted under the terminated child support order. A COURT OR CHILD SUPPORT ENFORCEMENT AGENCY ADMINISTERING THE CHILD SUPPORT ORDER MAY CONSIDER EVIDENCE OF HOUSEHOLD EXPENDITURES, INCOME VARIABLES, EXTRAORDINARY HEALTH CARE ISSUES, AND OTHER REASONS FOR DEVIATION FROM THE PRESUMED AMOUNT.
Effective Date: 03-22-2001
The Ohio Poverty Law Center will monitor the progress of HB 561 and, in particular, the proposed arrearage-only payment amendment. If anyone has any questions about HB 561, they should contact Mike Smalz at the Ohio Poverty Law Center, at firstname.lastname@example.org.
Those of you who read this blog have probably figured out that the continued existence of payday lending in the State of Ohio, despite legislative reforms in 2008, is a real sore point for me, and many other consumer advocates around the state. I have likened the various iterations of payday loans to Hydra, the mythical beast that grew two heads in place of every one that was cut off, making it almost impossible to kill. In Ohio, payday lenders are now pawn brokers, check cashers, mortgage loan lenders, small loan lenders, precious metal dealers, and credit services organizations. At least two companies are offering auto title loans – something that is strictly prohibited by the Short Term Loan Act – that Act under which not one lender is licensed. And if borrowers do not want to walk to a store front, one google of “payday” reaps hundreds of internet options – each claiming to be better and faster than the rest. This ever changing domain of lending is tough for states to get a handle on.
The federal Consumer Financial Protection Bureau (CFPB) began gathering information about the payday industry in January 2012 with a field hearing in Birmingham Alabama. In a countermove, the industry is pushing for federal legislation, HR 6139, known as the Consumer Credit Access, Innovation, and Modernization Act. This bill “[D]irects the Comptroller of the Currency to charter qualified nondepository creditors known as National Consumer Credit Corporations (Credit Corporations) to offer financial products or services.”. In short, this bill gives payday lenders a pass on CFPB authority, and an end run around state licensing and consumer protection laws. On July 24, 2012 a Deputy Comptroller for Compliance Policy from the Office of the Comptroller of Currency (OCC) testified before the Senate subcommittee hearing the bill, concluding: “…HR 6139 raises serious consumer protection, compliance, and safety and soundness issues by creating a new federal charter for companies concentrating on products and services most prone to abuse and that are most often targeted to minority populations, low-income neighborhoods, and communities with high concentrations of our military service members.” On October 5, 2012 41 state Attorneys General, including Mike DeWine, sent a letter to House and Senate leaders asking them to oppose HR 6139.
It is good we have advocates on the national front opposing this legislation, as well as other industry attempts to expand their scope and reach. For example, see the letter to the OCC urging the Comptroller to stop Urban Trust Bank from partnering with a payday lender and a pre-paid card issuer in order to evade state usury laws and make payday loans on prepaid cards.
Study after study confirms that a significant percentage of payday loan borrowers are borrowing because their expenses consistently exceed their incomes, a situation ripe for abuse. These high cost, short term loans are going to be on the market for the foreseeable future. Currently there seems to be no political will in Ohio to revisit this lending market. Nevertheless, we all need to be vigilant, and keep hacking away at the heads of the beast when we have opportunities to do so.