COLUMBUS - Ohio's top-ranking Republicans declined Thursday to endorse Senate Republicans' bill to replace Obamacare, saying they had "concerns" about a plan to phase out Medicaid expansion.
Gov. John Kasich and Sen. Rob Portman both support the expansion of Medicaid to low-income, childless adults in Ohio. Nearly a third of Ohioans getting coverage under the health care program have a substance abuse or dependence problem, the state says. Since Ohio continues to fight one of the nation's worst heroin epidemics, it's important for these people to have coverage for addiction treatment, Kasich and Portman believe.
The Senate bill's passage came into question hours after leaders unveiled it Thursday, as four conservative members of the chamber – enough to doom it to failure – said they would vote against the bill as written.
Portman refrained from condemning the bill outright.
"I continue to have real concerns about the Medicaid policies in this bill, especially those that impact drug treatment at a time when Ohio is facing an opioid epidemic," Portman said in a statement. He plans to review an upcoming cost analysis of the bill and will decide whether to vote on it based on the bill's final language, he said.
Kasich, who does not have a vote, was more forthright. He called out Senate Republicans for negotiating the details of the bill without including Democrats and "behind closed doors." That negotiating group included Portman.
The Senate plan unveiled Thursday would end the Medicaid expansion under President Barack Obama's health care law. It would reduce over three years the federal money that states get to cover the new enrollees over three years, starting in 2021 and ending in 2024.
The U.S. House passed a different health care bill in May that would cut off the extra federal Medicaid expansion money more quickly, in 2020.
Kasich and Portman both opposed that bill, in large part because of its Medicaid expansion phaseout. Both Republicans had said they were open to a gradual decrease in the federal money for expansion. But they had cited examples that gave the program more time than the three-year phaseout outlined Thursday by the Senate.
Without the federal money for Medicaid expansion, Ohio leaders would have to decide whether to pay for the new enrollees' health care coverage with state tax money or end their insurance coverage entirely. The state is already facing a budget crunch due to a sluggish economy.
Washington correspondent Deirdre Shesgreen contributed.