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Wednesday, July 23, 2014
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Published: Sunday, 3/31/2013

Expanding Medicaid won’t help Ohio

It is time to get power back to the states, where we get greater accountability

BY MATT A. MAYER

Gov. John Kasich is making a full-throated push to expand Ohio’s Medicaid program under Obamacare. But is this really the best way to serve our state’s most vulnerable citizens? For many Ohioans, the answer is a resounding no.

Opportunity Ohio commissioned a recent statewide poll on the governor’s proposal. The survey of 803 Ohioans initially found them equally divided: 46 percent opposed expanding Medicaid, and 46 percent supported expansion.

But when the respondents were told of the wide disagreement about how many more Ohioans would be covered by an expanded Medicaid program — estimates range from 275,000 to 901,000 — opposition to expansion grew to 48 percent, including two-thirds of Republican voters. And when they heard arguments against expansion, their views became even starker.

Roughly half of the Ohioans who were polled said they were very convinced by the argument that given disagreements over the costs of expanding Medicaid, the state shouldn’t rush into expansion until more facts are known. Almost half strongly agreed that Medicaid shouldn’t be expanded until waste, fraud, and abuse in the program are cleaned up.

Another 29 percent and 26 percent, respectively, said they found these two arguments somewhat convincing.

More important than whether Ohioans support expanding Medicaid in the state is whether they think it is a good program. Asked what words best describe Medicaid, only one out of six poll respondents selected “competent.” Even fewer opted for “resourceful,” “accountable,” “efficient,” “compassionate,” or “honest.”

In contrast, 20 percent said “efficient” was the least-descriptive adjective to apply to Medicaid. The others were not far behind. Given the countless reports about rampant waste, fraud, and abuse in Medicaid, as well as substandard medical outcomes for Medicaid patients, these findings are not surprising.

Our Republican governor’s enthusiastic embrace of such an inefficient, ineffective, uncompassionate federally driven program is surprising, especially because Medicaid devours state spending. So what is a better way to provide medical care to Ohio’s most vulnerable residents while protecting taxpayers?

How can we make sure that higher Medicaid spending doesn’t require us to shift scarce resources from education and other key programs? How do we become less dependent on a federal government that is broke and placing an enormous debt burden on our children and grandchildren?

We must get the locus of power over our lives back in Ohio. Politicians have been nationalizing more of our daily lives for the past 80 years. It is time to get power out of Washington and back to the states, where we get greater accountability and transparency from government.

The fact that Governor Kasich is losing the Medicaid expansion fight is proof of that reality. In 2010, after Washington took a chunk of the $106.5 billion in taxes Ohioans sent it to pay for bureaucracy, Ohio got back $11.5 billion for Medicaid. That money had lots of strings attached.

It is disrespectful of state sovereignty to have decisions in Washington drive such enormous budgetary issues. Ohio is more than capable of deciding how best to tend to our vulnerable populations.

With full control, Ohio can craft a Medicaid program that best meets the needs of our poor and protects taxpayers. Instead of sending our money to Washington, federal taxes should be cut.

That would allow Ohio directly to fund a Medicaid program that is designed and run here. The days of Ohio taxes subsidizing other states’ programs must end.

Our efforts to fix Medicaid and other key programs doesn’t start in Washington; it ends there. Instead of putting his hand out for federal money, Governor Kasich should put his hand up and lead the national fight, by both Republican and Democratic governors, to keep their states’ money and to get back power over Medicaid and other programs.

Many Ohioans think that expanding a costly and failing program is not the answer for Ohio. Fighting for the constitutional right to design a program that works for Ohio’s poor, at a cost that taxpayers can afford, is the answer.

Matt A. Mayer is president of Opportunity Ohio, a free-market research and advocacy organization in Columbus. Details of the Medicaid poll are available at opportunityohio.org.



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