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Published: Monday, 9/23/2013

Kasich’s Medicaid stance gains unlikely fans

E.J. DIONNE, JR.
WASHINGTON POST WRITERS GROUP
Gov. John Kasich speaks about his plans to expand Medicaid during a speech in the Statehouse in Columbus earlier this year. Gov. John Kasich speaks about his plans to expand Medicaid during a speech in the Statehouse in Columbus earlier this year.
COLUMBUS DISPATCH/CHRIS RUSSELL Enlarge

COLUMBUS — It was the last thing the Rev. Tim Ahrens expected to do during a chat in his book-lined office at the historic First Congregational Church here: He expressed admiration for Gov. John Kasich.

Pastor Ahrens is a progressive social activist whose house of worship has deep roots in the old Social Gospel movement. He has demonstrated and organized against Ohio’s conservative governor. In 2011, he even gave a kind of counter-State of the State message outside the Capitol while Mr. Kasich was presenting his plans inside.

Yet Mr. Kasich, a one-time scourge of labor unions who was a top lieutenant in Newt Gingrich’s revolution in the 1990s, has endeared himself to liberal and low-income Ohioans by insisting, loudly and incessantly, that his state participate in the Medicaid expansion under Obamacare. An unapologetic conservative is fighting the Tea Party and his own Republican legislature because he thinks the less privileged people of Ohio deserve health coverage.

Thus Mr. Ahrens’s surprising confession last week, offered with a rueful smile: “One of the things I admire about John Kasich — yes, I did say ‘admire’ — is that if he connects to an individual who is hurting, he will respond.” And having responded on the Medicaid issue, Mr. Kasich has gone all in.

“He has not wavered from that place,” said Mr. Ahrens, who chairs the Central Ohio Medicaid Expansion Coalition. “He has become a crusader. He will not let go of this.”

Mr. Kasich’s witness is important as an expression of his commitment to a form of evangelical Christianity that places a high priority on the poor. The governor told the Wall Street Journal last month of an encounter with a state legislator who disagreed with him on Medicaid.

At heaven’s door, Mr. Kasich preached, St. Peter is “probably not going to ask you much about what you did about keeping government small. But he is going to ask you what you did for the poor.”

At a moment when the Beltway wing of the GOP is on the verge of shaking the economy to its foundations in an effort to block Obamacare, there’s also a political lesson to be drawn from Ohio and from other states where Republican governors have embraced the expansion of Medicaid, which is a central component of the Affordable Care Act.

Just last week, Rick Snyder, Michigan’s Republican governor, signed a Medicaid expansion bill with an explanation that President Obama himself would endorse. “This is about the health of fellow Michiganders,” Mr. Snyder said.

In Pennsylvania, Gov. Tom Corbett once excoriated Obamacare but said he’d go along with a modified expansion. Another half-dozen Republican governors also have supported enlarging Medicaid, among them Chris Christie in New Jersey, Jan Brewer in Arizona, and Susana Martinez in New Mexico.

These chief executives usually follow the party line in being critical of the health law in principle. But they have responsibilities that the radical ideologues in Washington don’t have — to their local hospitals, to their economies, and, yes, to their constituents among the working poor who now lack insurance. They understand the difference between Obamacare as a right-wing bogeyman and the Affordable Care Act as a reality.

Another of Mr. Kasich’s new allies on Medicaid is Columbus Mayor Michael Coleman. The first African-American to lead the city, Mr. Coleman proudly describes himself as a “pro-business Democrat,” a coalition builder, and an advocate of school reform.

“Kasich and I don’t agree on too much,” Mr. Coleman, a 14-year incumbent, told me. “But on this one, he’s right.”

Like many other Americans in the middle of the country, the mayor finds Washington’s current antics entirely strange. He’s especially impatient with ideologues whose views are based on a sweeping anti-government philosophy instead of pragmatic thinking about what efficiently run government can achieve.

“Those people who talk that way have no real-life experiences,” Mr. Coleman said. The mayor then issued an invitation to a hypothetical congressional dogmatist — “Mr. Philosophizer,” he called him — to walk his city’s neighborhoods with him to learn about the problems of flesh-and-blood citizens.

It’s not clear that Mr. Kasich will win his fight on behalf of such citizens. Conservatives in his legislature worry as much about Tea-Party challenges as congressional Republicans do and could continue to block expansion.

If that happens, Mr. Ahrens said that advocates of broader Medicaid coverage are preparing to place the issue on Ohio’s ballot. Polls suggest it would win.

Tea-party “philosophizers” in Congress should accept Mr. Coleman’s invitation. Seen from the ground, expanding health coverage is a practical and compassionate goal.

Practicality and compassion are both missing in the manufactured rage against the abstraction known as Obamacare.

E.J. Dionne, Jr., is a member of the Washington Post Writers Group.



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