COLUMBUS - Republican lawmakers have backed off from an attempt by some to kill Gov. John Kasich's expansion of Medicaid to lower-income Ohioans, but they are battling to rein it in.
A new Ohio House proposal would force the Medicaid director to get approval for Medicaid expansion money every six months. To get the money, the director would go before the Controlling Board, a panel of six lawmakers and a Kasich appointee – the same group Kasich leveraged in 2013 when his party would not move the Medicaid expansion portion of Obamacare through the Legislature.
Over the weekend, Ohio's most conservative lawmakers wanted Kasich's Medicaid expansion gone – and indicated they were willing to hold the state's two-year budget hostage to do it. Some GOP legislators never forgave Kasich for what they saw as an abuse of executive power in 2013. They view health care for those low-income, childless adults as an unnecessary government expense.
Kasich, a Republican who has continued to champion Medicaid expansion, won’t sign a budget that kills it and is unlikely to accept restrictions such as the extra approval to spend Medicaid money. Still, some GOP lawmakers want to engage in brinksmanship on Medicaid expansion – not unlike when they passed a first-trimester abortion ban last December, only to have it vetoed by the governor. They control both chambers of the Ohio Legislature by large margins, but likely don’t have enough votes to override Kasich’s line-item veto of a Medicaid provision.
One way lawmakers discussed eliminating Kasich's Medicaid expansion was "freezing" the group of newly insured people. That kind of proposal would end coverage for many people within a year, the Kasich administration has said in the past.
That's similar to the way congressional Republicans proposed phasing out Medicaid expansion as part of a plan to replace Obamacare. Kasich opposed the plan because of the Medicaid changes. People covered by the expansion, his administration said, could lose coverage if they made enough money to become ineligible. Then, if their income dropped the following month, they would be unable to get back on Medicaid.
In the end, Ohio House Republicans settled on the Controlling Board restriction, proposing it Monday as an amendment to the state's two-year budget. They also added several other ambiguous restrictions.
Under the GOP proposal, the panel would be allowed to release money for Medicaid if Congress reduces the percentage of lower-income Ohioans on Medicaid. If Congress makes no changes, the panel would release money if Kasich makes "progress" in several areas, such as ensuring Ohioans have more information about the cost of health care procedures. "Progress" is not defined in the amendment.
The House's Medicaid restriction isn’t the final word. Republican lawmakers who control the House plan to send the state budget to the GOP-controlled Senate this week. The Senate will make its own changes before Kasich has the chance to veto items he doesn’t like. The process must wrap up before July 1.
When Kasich first expanded Medicaid with an end run around the Legislature, he used faith to justify it: When he stood at the pearly gates, he argued, he would have an answer for how he served the poor and needy. Democrats lauded the move.
Kasich says canceling or freezing Medicaid expansion will cut off medical care for people with addictions or mental illnesses.
Columbus bureau chief Chrissie Thompson contributed to this report.