Dueling Ohio House bills fight over Medicaid expansion

Kasich, Rep. Sears back more coverage

10/16/2013

COLUMBUS — A pair of dueling bills taken up for debate by lawmakers on Wednesday called expansion of Medicaid under the federal Affordable Care Act either the right prescription for Ohio or a drain on taxpayer resources with not enough to show for it.

Both measures could be moot by early next week. Gov. John Kasich has angered some fellow Republican lawmakers by bypassing them to take his Medicaid expansion plan directly to a budgetary panel chaired by a member of his administration.

“The reality is we have been spending months looking at the faces of the working poor, uninsured, childless adult population,” said Rep. Barbara Sears (R., Monclova Township), the most vocal GOP lawmaker supporting expansion.

“We have heard stories that make us cry and shake our heads,” she told the House Health and Aging Committee. “We have heard stories that make us want to be punitive to the few abusers of our programs and our systems. We have heard stories that point to monumental success with treatment and opportunity.”

She argued in favor of her bill, House Bill 176, that attaches expansion to 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.

But Rep. John Becker (R., Cincinnati) countered with House Bill 255, which would dramatically cut Medicaid eligibility for adults and eliminate a program allowing disabled workers who earn too much to buy Medicaid coverage.

“My intent with this bill is to give taxpayers a seat at the table in the Medicaid debate,” he told the committee. “I don’t intend to vigorously lobby for its passage. Rather I want to highlight the money that we are currently spending above federal minimums and a historical perspective. … Ohio would be better off with the reputation of being the business state rather than the welfare state.”

The two bills, to some extent, encapsulate the debate — one argument that expansion can be part of the solution to chronic health problems that hold people back and the opposite argument that Medicaid encourages an entitlement mentality that could lead to fewer people seeking work.

Meanwhile, a large number of the 60 House Republicans on Wednesday signed onto a letter to Mr. Kasich challenging the constitutionality of his plan to ask the Ohio Controlling Board to deliver what the General Assembly has so far refused to give him. The letter has no teeth beyond that.

“Obviously, there is a concern among House members about this approach,” said House Speaker Bill Batchelder (R., Medina), who was among those who signed it.

Lawmakers had inserted language into the state budget to prohibit efforts by the governor to move toward expansion without General Assembly approval, but Mr. Kasich vetoed that language before signing it into law at the end of June. Mr. Batchelder noted that a veto override is still a possibility.

The controlling board consists of six lawmakers plus one representative of the Kasich administration. It will vote on Monday on Mr. Kasich’s request to accept $2.56 billion in federal funds to finance adding to the rolls some 275,000 mostly working adults earning as much as 38 percent over the federal poverty level. That’s about $32,000 a year for a family of four.

Assuming the two Democrats on the panel join Mr. Kasich’s representative in the “yes” column, the governor would still need one of the four Republicans on the panel to side with him.

Mr. Batchelder said he will speak to his members on the panel.

Contact Jim Provance at: jprovance@theblade.com or 614-221-0496.