Kasich hopeful board OKs Medicaid growth

Ohio legislature avoided in effort to get $2.56B

10/19/2013

COLUMBUS — Gov. John Kasich said Friday he’s “optimistic” he’ll get the four votes needed to expand Medicaid to roughly 275,000 more Ohioans.

“We have a vote on Monday,” he said at the Cleveland Clinic. “Say your prayers this weekend.”

He spoke publicly for the first time about his plan to bypass the General Assembly, controlled by fellow Republicans, and ask the Ohio Controlling Board to accept $2.56 billion in federal funds for Medicaid expansion.

He never mentioned the board by name or the controversy surrounding the maneuver. But he did address concerns raised by critics who see the plan as an expansion of an entitlement system the nation can’t afford.

“This is not a program designed to encourage dependency,” Mr. Kasich said. “It is a program designed to construct a bridge so that people can be functioning in a way where they can contribute.”

At one point, he reached out to one of his critics, House Speaker Bill Batchelder (R., Medina), who this week joined 38 fellow Republicans in the chamber in signing a letter questioning the constitutionality of Mr. Kasich’s use of the controlling board.

“We’ve got like 26,000 veterans that are below the poverty line, and they can’t get help,” Mr. Kasich said. “Get this thing done. We’re going to help them, and I know Speaker Batchelder feels very strongly about this, about the need to help our veterans. I do as well. This is critical for us.”

The federal government has approved the Kasich administration’s plans to expand eligibility for Medicaid under the Affordable Care Act to those earning as much as 38 percent above the federal poverty level. That’s about $32,000 a year for a family of four.

Now he needs the controlling board to accept the funds to pay for it. Assuming the two Democrats on the panel join his own board chairman Monday to vote “yes,” Mr. Kasich will still need one Republican vote.

But a “yes” vote is almost certain to result in a lawsuit before the Ohio Supreme Court contesting use of the controlling board to subvert the General Assembly’s will.

Republican majorities in both the House and Senate voted to remove Mr. Kasich’s expansion proposal from the state budget before sending it to his desk. They then added language designed to prevent the governor from taking steps to enact the expansion without legislative approval. Mr. Kasich used his line-item veto authority to strip that language from the budget before signing it into law.

Although the final law no longer contained the prohibition, the conservative Buckeye Institute for Public Policy Solutions argued in a report issued Friday the legislature’s intent was clear.

“With this legislative timeline, it will be difficult, if not impossible, for the Controlling Board to approve the governor’s request for expanding the Medicaid program and also fulfill its statutory obligation to ‘take no action which does not carry out the legislative intent of the General Assembly,’ ” its report reads. “And failure to meet that statutory requirement will expose the Board to a court challenge.”

The threat of litigation also means a group gathering signatures for a November, 2014, effort to enact the expansion via the ballot box probably will continue beyond Monday’s vote.

“We are presently on the street with paid and volunteer signature circulators, and we intend to keep that activity going,” said Jon Allison, spokesman for the Ohio Alliance of Health Transformation, a coalition of business, health-care providers, and other groups promoting Medicaid expansion.

“It’s fair to say we will see what happens on Monday with the controlling board and see what impact that will have on our need to go forward,” he said. “It became pretty clear [this week] … that there could be a legal challenge.

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