John Kasich just thwarted Ohio GOP's Medicaid freeze. What's next?

COLUMBUS - Gov. John Kasich on Friday vetoed GOP lawmakers' plan to cripple Medicaid expansion – preserving access to government-provided insurance for many lower-income Ohioans – but the battle is far from over. 

Republican lawmakers think they have the votes to override Kasich's veto and reassert control over the state's biggest expense: Medicaid. If they do, it would be a first for lawmakers from Kasich's party, who have not overturned a single veto during the governor's six-plus years in office. 

Kasich struck 47 items from GOP lawmakers' budget late Friday. The number represents a stark increase from seven during his first year in office, highlighting the growing divide between the governor and his fellow Republicans.

For some GOP lawmakers, overturning Kasich's veto on Medicaid would culminate a crusade that started in 2013 when Kasich first went around legislators to expand Medicaid to more than 700,000 Ohioans. For others, it would be a chance to say "no" to President Barack Obama's Affordable Care Act – a mandate lawmakers believe they received from the same voters who sent President Donald Trump to the White House.

“You would be kidding yourself if you didn’t think that the folks on the 30th floor don’t have big red veto pen on all the great things that we’ve done in here,” Rep. Bill Seitz, R-Green Township, told lawmakers Wednesday, referring to Kasich's offices. “So, are we prepared to send them a message?”

GOP lawmakers want to end new enrollment in Medicaid starting July 1, 2018, for people who gained coverage under Obamacare.  At that point, those who dropped off the rolls, perhaps because they received higher wages during a given month, would be unable to re-enroll. Many Medicaid members drop off and re-enroll each year, so the freeze would end the health care program for them.

The Republican proposal does offer an exception for those with a drug addiction or mental illness,allowing them to enroll in Medicaid after mid-2018. That last-minute change was an attempt to win over more moderate Republicans who were concerned about giving $180 million to fight Ohio's heroin and opioid problem with one hand while taking away health care and drug treatment coverage with the other.

Kasich line-item vetoed the entire plan, enabling Medicaid expansion to continue as is – for now. The governor has spent months admonishing members of Congress for planning to cut off some Americans' government-subsidized health care – especially Medicaid expansion, for which the federal government currently foots most of the bill.

Back on his home turf, he didn't back down.

"We just don't think it's the right way to proceed," Kasich said late Friday. "We want to be in the position to help the mentally ill."

Now the question is whether Ohio's GOP lawmakers have the three-fifths majority in both chambers to overturn Kasich's action.

In the Ohio House, that's 60 of its 99 members. On Wednesday, House Republicans passed the two-year state budget, which included the Medicaid freeze, by a 59-40 margin. To override Kasich, they would need to pick up votes from some of the seven conservative Republicans who voted against the budget – people such as Rep. Paul Zeltwanger, R-Mason.

Zeltwanger voted against the budget because it cut money going to schools in his district, but he liked the efforts to rein in Medicaid spending. Zeltwanger told The Enquirer he would vote for an override.

"It’s a piece of the puzzle to try to get this under control," he said.

The path to overturning Kasich's veto seems simpler in the Ohio Senate. Republicans have a historic majority there and easily passed the budget, 24-8.

But some moderate Republicans in both chambers, including Dayton-area Sen. Peggy Lehner, don't support the move to hamstring the insurance program for lower-income Ohioans. Kicking people off "just doesn't seem right," she told The Enquirer.

Republicans likely would need to keep some moderates with them to overturn Kasich's veto.

Kasich has rejected GOP lawmakers' plans in the past, most recently blocking the so-called "heartbeat bill," which would have barred abortions after a fetal heartbeat was detected, as early as six weeks’ gestation. But lawmakers haven't challenged him on these vetoes.

Democrats will oppose any effort to restrict access to Medicaid, but much like in Washington, they don't have enough votes to stop their GOP colleagues after Trump's victory helped sweep Republicans into office.

Lawmakers also might try to reverse Kasich's decision to slash more than $200 million a year for counties and transit authorities. GOP lawmakers earmarked the money to offset losses from a sales tax the federal government no longer allows.

Unlike the effort to restrict Medicaid, here Republicans could get some support from their Democratic colleagues. Lawmakers on both sides of the aisle support giving money to counties and transit authorities for six years.

Without that veto override, Hamilton County stands to lose $15 million a year that it uses for basic services and to help cover the county's debt for the riverfront, stadiums and Union Terminal. But state officials worry they will lose money for the state by pushing for more.

The Ohio House has scheduled a session for Thursday, possibly for an override vote. The Ohio Senate could meet the following week. The override votes would be allowed anytime before the start of a new legislative session in January 2019. Any changes to Medicaid as the result of an override would need approval from Trump's administration.

Cincinnati Enquirer


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