COLUMBUS — A state budgetary panel on Monday approved federal funding that would provide Medicaid to an estimated 275,000 more Ohioans, a move that is expected to spur a lawsuit that will attempt to block the expansion.
The Ohio Controlling Board 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 through June 30, 2015.
Two Republicans joined the panel’s two Democrats and Gov. John Kasich’s appointed chairman to effectively do what the 132-member General Assembly would not — accept federal cash under the Affordable Care Act to add an expected 275,000 more Ohioans to the Medicaid rolls.
“Together with the General Assembly we’ve improved both the quality of care from Medicaid and its value for taxpayers,” Mr. Kasich said. “Today’s action takes another positive step in this mutual effort.”
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 replace Reps. Ron Amstutz (R., Wooster) and Cliff Rosenberger (R., Clarksville) permanently. Mr. Amstutz and Mr. Rosenberger are vying to replace Mr. Batchelder as the next speaker and were viewed as likely “no” votes.
Mr. McGregor and Sen. Chris Widener (R., Springfield) joined Rep. Chris Redfern (D., Catawba Island), Sen. Tom Sawyer (D., Akron), and Mr. Kasich’s appointed chairman, Randy Cole, in the “yes” column.
Mr. McClain, whose district stretches as far north as Seneca County, joined Sen. Bill Coley (R., West Chester) in voting “no.”
The use of a seven-member panel to draw down federal funds that the Republican-controlled General Assembly tried to block immediately will be challenged to the Ohio Supreme Court.
Maurice Thompson, director of the 1851 Center for Constitutional Law, cited the last-minute game of musical chairs as further evidence of the weakness of the move.
“I think they wanted to make it 5-2 instead of 4-3 to make the vote look more legit,” he said. “What it does to us is make the vote look more illegitimate. And what it should also show a court is that, in any kind of administrative board where people can be switched out the same day to expedite a vote one way or the other, there’s a need for legislative consideration of the issue and also strict judicial oversight over such bodies that can be ends-oriented instead of means-oriented.”
Mr. Batchelder put the “yes” vote on the panel despite joining Mr. McClain and 37 other House Republicans last week in signing a letter challenging the constitutionality of Mr. Kasich’s maneuver.
The federal government has promised to pay 100 percent of the cost of expansion for the first three years under the Affordable Care Act. It would gradually reduce the reimbursement rate to 90 percent.
The expansion is expected to draw $13 billion in federal aid to Ohio over seven years.
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 starting Jan. 1 as one option to comply with the Affordable Care Act’s mandate that most Americans must acquire coverage. For a family of four, that translates into about $32,000 a year.
The administration estimates that 366,000 more Ohioans would be eligible under those terms. But it expects a net gain in the rolls of 275,000 as others move off as certain employers are required to provide coverage for workers under the Affordable Care Act.
A mix of business groups, doctors, hospitals, health and social organizations, and labor unions united to back Mr. Kasich, arguing that the move would create health-care jobs while providing care for the working poor, mentally ill, veterans, and addicts.
But while Mr. Kasich has attempted to separate that decision from the broader Affordable Care Act, Mr. Redfern, who doubles as Ohio Democratic Party chairman, wasn’t about to let people forget where the funding for the expansion is coming from.
He remained skeptical of the long-term prospects of expansion, stressing that Monday’s vote sustains it only through the current budget cycle.
“The past is prologue to many of us who lived through Governor Taft’s decision [in 2003] to roll back [Medicaid eligibility for childless adults] from 100 percent to 90 percent,” he said.
Fellow Republicans stripped the language from his budget proposal and took the extra step of adding language designed to prevent the governor from trying to expand Medicaid without the General Assembly’s approval. Mr. Kasich vetoed that language before signing the budget into law.
Without the additional federal funds, state Medicaid Director John McCarthy estimated the expanded program would have run out of cash around July 1, 2014.
“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), who has faced criticism for backing expansion.
“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,” Ms. Sears said.
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