Wednesday, May 23, 2018
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Good Medicaid ruling

The state Supreme Court was right to reject a challenge to expanding Ohio’s program of low-income health insurance

The Ohio Supreme Court acted properly in authorizing state government to expand its Medicaid program of health insurance for low-income Ohioans. Because of the court’s decision — and the sensible leadership of Gov. John Kasich — 275,000 mostly working-poor adults will get vital coverage starting Jan. 1.

The high court’s 4-3 ruling late last week made the decision appear closer than it was. None of the justices bought the arguments of six Republican state lawmakers and two anti-abortion groups that sought to block Governor Kasich’s expansion plan.

The plaintiffs objected to Mr. Kasich’s use of the state Controlling Board to approve his proposal after the GOP-controlled General Assembly refused to vote on it. They claimed the legislature had shown its intent when it inserted a provision in the state budget prohibiting the Medicaid expansion. But the Republican governor vetoed that language, preventing it from becoming law.

Writing for the court majority, Chief Justice Maureen O’Connor noted that lawmakers did not try to override that veto. As a result, she said, their initial vote against the expansion has no force or effect. “Any other conclusion would create a constitutional crisis,” she added.

Justice Terrence O’Donnell went even further in his dissent, saying the Supreme Court should simply have dismissed the case. “This case involves an impermissible judicial foray into the province of the legislature and raises a political question ... that we ought not to answer,” he said.

The dreary political back-and-forth should not obscure the importance of the Medicaid plan, which polls suggest most Ohioans support. The federal government will pay for nearly all of the expansion under the Affordable Care Act, providing $13 billion over seven years.

By ensuring health care before emergencies arise for people who previously could not afford insurance or were denied it because of pre-existing conditions, the expansion will save lives and prevent serious illnesses. The Ohioans covered by the expansion include 26,000 veterans and their families, and other disabled and homeless people.

Expansion also will save state and local governments a lot of money, create jobs, strengthen the finances of Ohio hospitals, and prevent costs of treating people who lack coverage from being shifted to employers and people who have private insurance.

Now that the expansion is imminent, lawmakers should forget about attempts to weaken the authority of the Controlling Board, which makes adjustments to the state budget. They should abandon efforts to apply the state’s savings from the expansion to yet another regressive and unnecessary tax cut.

And now that Mr. Kasich has won this victory, he might want to reconsider his refusal to set up a state exchange to sell insurance under the Affordable Care Act, rather than continue to rely on the problem-plagued federal exchange.

Six of the seven justices who ruled in the Medicaid case are Republicans. Tea Party types already are making noises about recruiting challengers to the justices who face re-election next year.

Let them. Such contests would give Ohio voters an opportunity to call the bluff of ideological extremists. And they might even stiffen the spines of Republican lawmakers who think that avoiding primary opposition matters more than representing their constituents adequately.

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