Legislative Budget Office of the Legislative Service Commission
were also below both their monthly and YTD estimates, by $31.6 million (2.2%) and
37.0 million (1.2%), respectively. Including both the GRF and non-GRF, all funds Medicaid
expenditures were $46.2 million (1.8%) below estimate in September and $99.5 million (1.4%)
below the YTD estimate at the end of September. As a joint federal-state program, both GRF
and non-GRF Medicaid expenditures contain federal and state dollars.
Table 5 shows GRF and non-GRF Medicaid expenditures for the Ohio Department of
Medicaid (ODM), the Ohio Department of Developmental Disabilities (ODODD), and six other
sister” agencies that also take part in administering Ohio Medicaid. ODM and ODODD account
for about 99% of the total Medicaid budget. Therefore, they generally also account for the
majority of the variances in Medicaid expenditures. The other six agencies – Job and Family
Services, Health, Aging, Mental Health and Addiction Services, State Board of Pharmacy, and
Education – account for the remaining one percent of the total Medicaid budget. Unlike ODM
and ODODD, the six “sister” agencies incur only administrative spending.
Table 6 shows all funds Medicaid expenditures by payment category. Expenditures were
below their YTD estimates for all four payment categories. Administration ($48.8 million, 17.9%)
had the largest overall negative variance, followed by Fee-For-Service (FFS, $30.4 million, 1.2%),
Managed Care ($15.7 million, 0.4%), and Premium Assistance ($4.6 million, 1.7%).
The variance in the Administration category is mostly due to timing and is expected to
smooth out throughout the fiscal year. The FFS variance is largely due to lower than expected
spending in the Ohio Medicaid Schools Program (MSP). MSP allows school entities to be
reimbursed for Medicaid covered services, certain administrative activities, and specialized
transportation provided to eligible children aged 3 to 21 years. Services are delivered through
an individualized education program designed to enable a child to participate in school. Any
qualified local education agency may participate in MSP voluntarily.
Primary and Secondary Education
This category of GRF expenditures includes all GRF spending by the Ohio Department of
Education (ODE). YTD spending in this category was under estimate by $41.4 million (1.9%) at
the end of September. This variance was driven by negative variances in two line items:
00550, Foundation Funding, and 200573, EdChoice Expansion.
Item 200550 supplies the bulk of the state’s subsidy payments for public school students
to school districts, joint vocational school districts, community and STEM schools, and
nonpublic schools through the state’s voucher programs. This item is the usual culprit when
there are significant variances in the Primary and Secondary Education category. This is partly
because of the size of the appropriation ($6.94 billion for FY 2020) but mainly because
payments are based on data that are updated throughout the year. For FY 2020, however,
foundation payments are based on FY 2019 amounts, so there might be more stability in this
item than has been typical in prior years. The YTD variance for item 200550 was a negative
19.9 million at the end of September.
Item 200573 provides payments for students who obtain state-paid Educational Choice
(EdChoice) scholarships through the income-based expansion of the program. The estimates
spread the appropriation out into two payments of $28.6 million each. Actual payments will be
more evenly spread out. The YTD variance for item 200573 was a negative $16.6 million at the
end of September.
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