COLUMBUS — In a decision that could have far-reaching effects, a federal appeals court ruled Tuesday that Ohio must count an applicant’s spouse as a member of his family when determining eligibility for financial assistance to pay Medicare bills.

A three-judge panel of the Cincinnati-based U.S. 6th Circuit Court of Appeals told the state it can’t exclude a beneficiary’s spouse when it comes to income calculations simply because the federal law doesn’t define the word “family.”

At issue is a program under Medicaid, the federal-state insurance program for the poor, that helps low-income Ohioans pay their premiums, co-payments, and deductibles under Medicare, the federal health insurance for senior citizens.

The larger the family, the more a beneficiary may earn and be eligible for that financial help.

The court sent the case back to U.S. District Court in Columbus where the plaintiff’s attorney, Miriam Sheline, plans to ask the judge to certify a class of between 80,000 and 100,000 people who would be affected.

“This benefit was to provide Medicaid premium assistance for things Medicare doesn’t cover … for individuals whose family incomes were below the federal poverty level,” said Ms. Sheline, an attorney with Pro Seniors, Inc., a Cincinnati-based nonprofit providing legal assistance for seniors.

“To say an individual who is a family of two or four should be denied that benefit when a larger income is needed to support a larger family is nonsensical,” she said.

She said this is the first circuit court to address Ohio’s interpretation of the law, which 16 other states share.

The three plaintiffs were Joseph Turner, now 77, of Lima; Leslie George Wheaton, 71, of Batavia; and George Hart, 63, of Logan, who is disabled. All three have wives who are not eligible for Medicare and have no income of their own.

“Ask 100 Americans whether a 74-year-old man’s ‘family’ includes his wife who lives with him, and every one of those Americans will likely say yes,” 6th Circuit Judge Raymond M. Kethledge wrote. “But the Ohio Department of Medicaid answered no, with the result that it denied Joe Turner’s application for benefits under the Medicaid Act.”

The Ohio Department of Medicaid, the defendant in the case, declined to comment, saying it was reviewing the decision. It could ask the entire 6th Circuit bench to reconsider the case or seek an appeal to the U.S. Supreme Court.

Ohio maintained during the case that the only time it would count the spouse was if both were eligible for Medicare. The court did not buy the state’s argument that its interpretation was reasonable given that the federal law requiring that assistance under Medicaid is ambiguous.

“It should have been clear to Ohio that the word ‘family,’ as used in the provisions here, does not mean whatever the state’s officials want it to mean, but instead includes at least a beneficiary’s resident spouse,” Judge Kethledge wrote.

Contact Jim Provance at: jprovance@theblade.com or 614-221-0496.

First Published September 2, 2015, 4:00 a.m.