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Ohio nears Medicaid expansion

Controlling board to mull Kasich’s request Oct. 21


The state is asking for $561.7 million in federal funds for the period between Jan. 1 and June 30, 2014, and $1.99 billion for the year ending June 30, 2015. The expansion is expected to draw a total of $13 billion in federal funds to Ohio over the next seven years.

The Columbus Dispatch Enlarge

COLUMBUS — Instead of 132 lawmakers, six apparently will decide whether roughly 275,000 more Ohioans will be added to the Medicaid rolls under the federal health-care law.

For eight months, Gov. John Kasich’s Medicaid expansion plan has gone nowhere with fellow Republicans, but on Friday he took steps to bypass the General Assembly and ask a bipartisan, mostly legislative panel to accept nearly $2.6 billion in federal funds to pay for it.

The Ohio Controlling Board, which usually moves state funds around and gives one last look at already-approved grants on the way out the door, will consider the request Oct. 21. The vote would allow Ohio to expand income eligibility for the federal-state health insurance of last resort to those earning as much as 38 percent over the federal poverty level. That’s roughly $32,000 a year for a family of four.

The panel consists of four Republican and two Democratic lawmakers plus one Kasich appointee. Assuming the two Democrats join Mr. Kasich’s board president in voting “yes,” the governor still would need one Republican vote.

“The controlling board has the authority to adjust federal appropriations levels,” said Greg Moody, director of Mr. Kasich’s Office of Health Transformation. “[Medicaid Director] John McCarthy has submitted a request to the controlling board that would allow a federal appropriation at a level that would allow us to receive and expend money. We believe the only remaining action is to extend coverage.”

The state is asking for $561.7 million in federal funds for the period between Jan. 1 and June 30, 2014, and $1.99 billion for the year ending June 30, 2015. The expansion is expected to draw a total of $13 billion in federal funds to Ohio over the next seven years.

The federal government, which approved Ohio’s expansion late Thursday, has promised to pay 100 percent of the cost of the expanded population for three years and then gradually would reduce the reimbursement to 90 percent. The additions to the rolls are expected to be mostly working adults because any children in those households are eligible under existing law.

“The controlling board does not have authority to change appropriation levels for [state general revenue] funds, but it does have the authority to change appropriation levels for federal funds,” Mr. Moody said. “This is within the controlling board’s authority to act.”

The move could to lead to litigation.

“There is a statute that allows the controlling board to appropriate federal funds not previously approved by the legislature, but any action has to be consistent with the General Assembly’s intent,” said Maurice Thompson, director of the 1851 Center for Constitutional Law.

“[The General Assembly] pulled the very same expansion from the budget and passed a budget that included a prohibition against this kind of expansion that was only removed when it was [line-item vetoed] by Governor Kasich,” he said. “The General Assembly’s intent is pretty clear.”

Rep. Ron Amstutz (R., Wooster), a controlling board member who wants to be the next Ohio House speaker, also isn’t happy with the move.

“I have grave concerns about the place, the time, and the substance of this proposed controlling board action,” he said. “Based on our solid track record of passing tough bills, I would expect a far superior and more creative solution by legislative enactment than what I fear may result from effectively crimping the legislative process.”

Cathy Levine, co-chairman of Ohio Consumers for Health Coverage, commended Mr. Kasich for doing what it takes to make expansion happen.

“Chambers of commerce, employers, providers, insurance companies, consumers, faith groups — a majority of whom are often at loggerheads — all agree,” she said. “There have been numerous studies that say this will be good for the health of Ohioans and good for the economy. This should have been a slam dunk.”

The six legislative members of the controlling board are Mr. Amstutz, Rep. Chris Redfern (D., Catawba Island), Sen. Bill Coley (R., West Chester), Sen. Chris Widener (R., Springfield), Sen. Tom Sawyer (D., Akron), and Rep. Cliff Rosenberger (R., Clarksville).

The panel’s president is Kasich appointee Randy Cole, policy adviser for the Ohio Office of Budget and Management.

None of the Republican legislators is seen as a likely “yes” vote, but House and Senate leaders have been known in the past to change the makeup of a panel, if only for one meeting, to ensure a desired result.

“It seems likely that Governor Kasich’s attempts to score political points by bashing Obamacare while seeking to benefit from one of its central components, the expansion of Medicaid, has led to needless confusion and delays, but what ultimately matters is health care becoming a reality for 275,000 of Ohio’s working poor,” said Matt McGrath, campaign spokesman for Cuyahoga County Executive Ed FitzGerald, Mr. Kasich’s likely Democratic opponent next year.

Contact Jim Provance at: or 614-221-0496.

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