Expand Ohio Medicaid

Gov. Kasich is right to bypass a useless legislature; now he needs to ensure his Plan B will work


When the Republican-controlled General Assembly isn’t making life harder for most Ohioans, it isn’t doing much of anything else. GOP Gov. John Kasich is right to work around lawmakers of his own party who have rejected his sensible proposal to expand the state Medicaid program of health insurance for working-poor Ohioans and their families.

Instead, the governor plans to use the state Controlling Board as his vehicle to pursue Medicaid expansion. Now he needs to make sure he has enough votes from board members of both parties to approve the proposal next week.

Mr. Kasich seeks to invoke the Affordable Care Act to make 275,000 more Ohioans eligible for health coverage under Medicaid starting next January. Most of these people are childless adults who are working but are too poor to buy private insurance — even subsidized coverage on Ohio’s new Obama-care exchange — that their jobs don’t provide. Others are poor children and their parents who do not now qualify for Medicaid.

Some 18,000 Lucas County residents would be newly covered by the governor’s proposal; so would 26,000 military veterans across Ohio. The health reform law would provide $13 billion in federal aid over seven years, much of it from Ohio taxpayers, to subsidize the expansion — nearly all of its projected cost.

The Controlling Board, composed of six lawmakers (four of them Republicans) and a representative of the governor, is scheduled to consider the expansion plan on Oct. 21. The board is authorized to amend the state budget to receive money from nonstate sources.

Greg Moody, director of the Governor’s Office of Health Transformation, told The Blade’s editorial page that accepting federal aid for Medicaid expansion is within the board’s powers. Opponents contend that board actions must reflect the intent of the legislature, which has balked at expansion. The dispute may wind up in court, but that is no reason for the board not to proceed in the meantime.

And there is every good reason for the expansion to occur. It will save the state money, increase tax revenue, and stimulate job creation and economic development. It will reduce costs for employers and individuals with private insurance who now must subsidize expensive, uncompensated emergency-room care for people who lack coverage.

Medicaid expansion will create more-stable funding for hospitals. It will make the state healthier, physically and mentally, and reduce welfare dependence. Polls suggest that most Ohioans favor it. Federal regulators have approved the governor’s proposal.

Yet most GOP lawmakers have shown themselves to be more concerned about not offending an Obamacare-hating fringe than with helping hundreds of thousands of Ohioans. They have delayed acting on Mr. Kasich’s proposal for eight months so they could “study” the issue.

A product of such scrutiny was a mostly toothless “reform” proposal offered last week by Senate Republicans. Instead of expanding eligibility, the plan seeks to restrict it even further in the name of limiting growth in Medicaid spending.

Complaints from lawmakers and other critics that Ohio’s Medicaid program is wasteful are unfounded. The program has saved $3 billion during the governor’s term without reducing the quality of health care or access to it, in such areas as long-term care for elderly Ohioans.

Columbus has wasted enough time. Governor Kasich should do what he needs to do to assemble a favorable majority on the Controlling Board for Medicaid expansion. Republican legislative leaders should not block that process.

And while most GOP lawmakers continue to answer to their Tea Party masters, other Ohioans might ask themselves why they should continue to elect politicians who don’t represent them.