This week, our In Focus section reviews two updates out of Ohio. The first is a Section 1115 Medicaid waiver, to be known as Healthy Ohio, which would implement a modified health savings account model for adult Medicaid beneficiaries in the state with the exception of individuals who are aged, blind, or have disabilities. Healthy Ohio also proposes a voluntary employment support program, as well as encourages transition to private insurance coverage, including a transitional spending account for enrollees shifting from Medicaid to the private market. Ohio’s Medicaid agency estimates potential savings of nearly $1 billion from the program over a five year period. The second update relates to the planned transition to a single eligibility determination for individuals with disabilities and mental illness, eliminating the need for both Supplemental Security Income (SSI) eligibility determinations and Medicaid eligibility determinations. The state estimates that as a result more than 400,000 Ohioans will convert to full Medicaid without spend down requirements in July 2016, pending State Plan Amendment approval.