John McCarthy, the Ohio Medicaid director, speaks during the Controlling Board meeting on the Medicaid expansion proposal today in Columbus.
The Columbus Dispatch, Eamon Queeney Enlarge
COLUMBUS — A little known budgetary panel today voted 5-2 to accept $2.56 billion in federal funds to pay for the controversial expansion of the federal-state health insurance of last resort.
Two Republicans joined the panel’s two Democrats and Gov. John Kasich’s appointed chairman to do what the 132-member General assembly would not — expand eligibility for Medicaid to some 275,000 additional Ohioans.
But the maneuver is expected to draw a legal challenge.
A few hours before the vote, House Speaker Bill Batchelder (R., Medina) named Reps. Jeff McClain (R., Upper Sandusky) and Ross McGregor (R., Springfield) to the panel to permanently replace Reps. Ron Amstutz (R., Wooster) and Cliff Rosenberger (R., Clarksville), respectively. Mr. Amstuz and Mr. Rosenberger are vying to replace Mr. Batchelder as the next speaker and were seen as likely “no” votes.
Mr. McGregor, a moderate Republican known to occasionally break with his caucus, voted “yes,” joining with Sen. Chris Widener (R., Springfield), Rep. Chris Redfern (D., Catawba Island), Sen. Tom Sawyer (D., Akron), and Mr. Kasich's board chairman, Randy Cole.
Mr. McClain, whose district stretches as far north as Seneca County, joined Sen. Bill Coley (R., West Chester) in the minority.
“Our members want to seriously quicken the pace of a series of bills that relate to Medicaid reforms and improving the opportunities for low-wealth and struggling citizens to move up and off of having a need for Medicaid,” Mr. McCain said.
Mr. Batchelder put a “yes” vote on the panel despite having joined Mr. McClain and 37 other House Republicans last week in signing a letter challenging the constitutionality of using the controlling board to sidestep the General Assembly as a whole.
The federal government has promised to pay 100 percent of the cost of expansion for the first three years under the Affordable Care Act.
Barring a successful court challenge, those earning as much as 38 percent over the federal poverty level will be able to sign on to Medicaid beginning Jan. 1 as one option to comply with the Accordable Care Act’s mandate that most Americans must acquire coverage. For a family of four, that translates into about $32,000 a year.
Mr. Kasich bucked the conservative wing of his own party in proposing the expansion in February, making the financial and moral case that it was the right thing to do, regardless of his general distaste for what is commonly called Obamacare.
But fellow Republicans stripped the language from his budget proposal and took the extra step of adding language designed to prevent the governor from taking steps to expand Medicaid without the General Assembly’s approval.
Mr. Kasich used his line-item veto authority to strike that language before signing the budget into law. When the legislature still failed to vote eight months after he proposed it, Mr. Kasich turned to the little know Ohio Controlling Board to do an end-run around it.
The panel usually moves money around, giving one last look at grants and other state funding before they go out the door. But it has also acted in the past to accept federal dollars that became available between budget votes.
“I’m disappointed that the chairman of the (House) Finance Committee (Mr. Amstutz) did not have more robust hearings on Medicaid expansion,” said Rep. Barbara Sears (R., Monclova Township), probably the most outspoken House Republican on the issue.
“I would have liked a full conversation, but I am very comfortable with this being brought to the controlling board, which was created and run by the legislature,” she said.
Her own bill combining the expansion with an exit strategy if the federal government doesn’t live up to its promises and efforts to contain costs, improve health outcomes, and move Medicaid recipients into work.
The expansion is expected to draw $13 billion in federal aid to Ohio over seven years.