The version of the next state budget just introduced by the Republican-controlled Ohio Senate ignores GOP Gov. John Kasich’s sensible proposal to expand the Medicaid program of health insurance for working-poor and disabled Ohioans. Worse, Senate Republicans are looking for ways to restrict, rather than broaden, Medicaid eligibility.
That’s bad public policy. And even within the cramped ideology of GOP state lawmakers, such narrow-mindedness could prove bad politics as well.
The case for expanding Ohio’s cost-effective, innovative Medicaid program is compelling to just about everyone, except Republican legislators and the anti-Obamacare zealots they fear might challenge their re-election bids next year.
Expansion would insure hundreds of thousands of low-income Ohioans for primary and preventive care. That would reduce the costs they otherwise would incur for emergency health care they couldn’t pay for — costs that are now borne by employers, taxpayers, and people with private coverage.
Expansion would create jobs, increase tax revenue, save the state money on such things as treatment of mental illness and drug addiction, and generate economic development. And the federal government would pay for nearly all of Ohio’s expansion under the Affordable Care Act.
Republican lawmakers offer the excuse that they don’t trust Washington to meet its funding commitment for Obamacare — $13 billion for Ohio — if federal revenue becomes tight in future years. They are familiar with such irresponsible behavior, having slashed aid to Ohio school districts and local governments to balance the current state budget.
But Mr. Kasich has made clear that he will not proceed with Medicaid expansion if the promised federal aid is not forthcoming. Do GOP lawmakers not trust their governor either?
As another excuse for their inaction, GOP senators note that the budget bill passed by the Republican-majority House doesn’t include Medicaid expansion. But state Rep. Barbara Sears (R., Monclova Township), the House GOP floor leader, is proposing separate legislation that would carry out essential elements of the governor’s proposal.
The bill also requires many of the Medicaid changes Republican lawmakers demand, in such areas as managed care, anti-fraud initiatives, and bureaucratic accountability. It deserves prompt consideration. But it need not, and should not, prevent the inclusion of Medicaid expansion in the next two-year state budget.
Instead, Senate leaders say they want to “study” and “debate” expansion, and propose “reforms” in the misty future. At best, that is an excuse for doing nothing.
At worst, it provides lawmakers an opportunity to impose the same sorts of restrictions on Medicaid eligibility — time limits, inflexible work requirements — that have been applied to state welfare programs. Those changes have further impoverished Ohio’s poorest families, and especially children.
Governor Kasich insists he remains committed to getting his Medicaid expansion passed. He might want to convey that message even more forcefully to the members of his party who run the Statehouse, showing that GOP lawmakers have more to fear from defying him than they do from disobeying the Tea Party.
The General Assembly has until the end of this month to adopt the new state budget. Whatever else lawmakers do or don’t do, they need to make Medicaid expansion part of that budget.
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