Monday, May 21, 2018
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Taking control

If self-serving lawmakers resist Medicaid expansion, Governor Kasich must go around them

The Republican lawmakers who control Ohio’s General Assembly have made clear that they are more interested in preserving their own political power than promoting the interests of the people they supposedly represent. Rather than expand the state’s Medicaid program, and provide needed health insurance to 275,000 more working-poor Ohioans, most GOP legislators are cowering before Tea Party extremists as they pursue their futile quest to destroy Obamacare.T

Lawmakers continue to repudiate Republican Gov. John Kasich’s pleas to take advantage of the $13 billion in federal aid the state would get to expand Medicaid under the Affordable Care Act starting January 1. A petition drive aimed at placing the issue before voters if lawmakers fail to act is making progress. But such a vote would not occur before next year — an expensive and intolerable delay.

If lawmakers refuse to work with the governor, Mr. Kasich must work around them. He has a promising vehicle to do so, but likely will need the help of Democrats who claim to favor expansion.

The Ohio Controlling Board is authorized to make changes to the state budget in limited circumstances, as when money is available from sources outside the standard budget process. The federal aid that would pay for nearly all of Ohio’s Medicaid expansion would seem to qualify, although it would require some state spending. The board’s seven members include a representative of the governor and six lawmakers, two of them Democrats.

Legal experts say the Controlling Board could effectively enact the Medicaid expansion by voting to accept the federal funds. That would not be unprecedented: The board has voted to take money from Washington for the state under economic stimulus programs and for the Race to the Top education initiative.

Going around lawmakers of his party would be risky for the governor. The administration is wary of discussing the option publicly, claiming it still would prefer legislative action. But Mr. Kasich is surely aware that time is running out.

A successful Controlling Board vote on Medicaid expansion probably would require the support of its Democratic members. Democratic legislators have vehemently criticized their Republican colleagues for blocking expansion.

Yet Ohio Democratic Party chairman Chris Redfern, a state lawmaker who sits on the Controlling Board, won’t declare support for the board option, saying it could face a legal challenge and would limit public debate. Both of these excuses sound flimsy.

It’s no more acceptable for Democrats to play cheap partisan politics with Medicaid expansion than it is for Republicans. The prospect of denying Mr. Kasich a major policy victory before his re-election campaign next year should be far less important to Democrats than ensuring that the expansion succeeds.

And that success in the legislature grows less likely every day. Republican House Speaker William Batchelder continues to trot out the old wheeze that Washington might not honor its commitment to subsidize Medicaid expansion, leaving the state to pay the bill.

But Mr. Kasich has vowed that in the unlikely event federal aid dries up, he will halt the expansion. That leaves open the question of whether the Republican speaker trusts the Republican governor.

Medicaid expansion would save the state money, raise revenue, create jobs, expand Ohio’s economy, stabilize hospitals’ finances, cut the cost of unpaid medical care for people with private insurance, and improve public health. Polls show that most Ohioans favor expansion. It needs to happen, now.

If the General Assembly continues to balk, Governor Kasich should not hesitate to invoke the Controlling Board option. And feckless lawmakers of either party who work to block the expansion will owe their constituents an explanation of whom they truly represent.

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