Kasich’s Medicaid choice aligns with his approach

Ohio Governor John Kasich speaks to a crowd at Early Express Services in Dayton
Ohio Governor John Kasich speaks to a crowd at Early Express Services in Dayton

COLUMBUS, Ohio: Yes, Ohio’s Republican governor is supporting the expansion of Medicaid, one of the government’s biggest programs.
While that looks like a contradiction for a conservative governor who’s rejected federal stimulus money, the move by Gov. John Kasich is right in line with his matter-of-fact approach.
Kasich proposed the Medicaid expansion in his two-year budget plan framing his decision as recapturing Ohio taxpayers’ federal money.
The federal government will pay the entire cost of the Medicaid expansion for the first three years, gradually phasing down to 90 percent – still well above the state’s current level of 64 percent.
Many Republicans are averse to President Barack Obama’s signature health care law and resistant to expanding government programs.
But Kasich insists his decision to broaden Medicaid coverage “is not an endorsement” of the health care overhaul and separate from the law’s mandate that almost everyone obtain health insurance.
Nonetheless, the Medicaid expansion is one of the key components of the law. Of the nearly 30 million people expected to gain insurance coverage under the law, about half would get it from the Medicaid expansion.
Kasich’s decision is significant not only because Ohio is a political bellwether, but because of his previous service in Congress, where as chairman of the House Budget Committee in the late 1990s he helped pass major legislation to reduce federal debt.
The governor is casting his move as an effort to maintain the state’s competitive edge by taking advantage of federal tax dollars to create a healthier workforce.
Now, he’ll have to persuade Republicans who control the Legislature to back the plan despite the fact that many dislike the law’s mandated coverage and campaigned against it just a few months ago.
“When you look at the facts, when you strip out ideology or, you know, political considerations and you kind of focus on what makes the most sense, I’m very hopeful at the end of the day that they will get this,” Kasich told reporters.
The state would see $2.4 billion from the federal government to cover those newly eligible for Medicaid over the next two years beginning in July, and $13 billion over the next seven years, according to the Kasich administration.
The governor has powerful groups supporting his cause, including the Ohio Chamber of Commerce, the Ohio State Medical Association and AARP Ohio.
Some conservative groups have criticized his decision, including the Virginia-based Americans for Limited Government.
“Thanks to Gov. Kasich, the American people will be paying interest on Ohio’s Medicaid expansion for posterity,” Bill Wilson, the organization’s president, said in a statement.
Kasich, a former Fox News commentator, hasn’t been afraid to confront interest groups to push through his ideas.
Just days after his 2010 election, he issued a stern warning for lobbyists to put aside business as usual or they’d be left out of the budget-writing process that is a livelihood to many.
“Please leave the cynicism and the political maneuvering at the door because we need you on the bus,” he said. “And if you’re not on the bus, we will run over you with the bus. I’m not kidding.”
The governor defended his decision to expand Medicaid this week on the conservative website RedState.com.
“Whenever federal resources are being distributed to the states _ and there’s nothing we at the state level can do to prevent that spending _ then Ohioans shouldn’t be robbed of their fair share,” Kasich wrote.
“I make no apologies for ever standing up for my state and any governor who would is in the wrong job,” he continued.
The state anticipates almost 366,000 Ohioans will be eligible for coverage beginning in 2014 by expanding Medicaid, the health program for the poor that already provides care for one in five residents in the state.
To be sure, Kasich has his own reservations about whether Washington will honor its financial commitments for the latest Medicaid expansion.
His budget proposal calls for an automatic “opt-out” trigger. So if the federal government doesn’t pick up its share of expanded coverage, the program for newly eligible Ohioans would shut down and state taxpayers wouldn’t be stuck with the bill.
Kasich has been quick to reject federal dollars before.
Even before he was elected in 2010, Kasich declared dead a project that would have created passenger train service between Cincinnati, Columbus and Cleveland. He said the service would be too slow and questioned whether enough people would ride it.
Instead, Kasich wanted to use the $400 million in federal stimulus money on other transportation projects such as road construction or freight lines. When that idea fell flat, he sought to have the dollars returned to the federal treasury to reduce the deficit if it couldn’t be used to meet other Ohio needs.
Federal officials sent the money to other states, much to Kasich’s chagrin.
Kasich’s spokesman Rob Nichols said the two decisions aren’t comparable.
“The opportunity to provide health care coverage to the working poor versus a slow train that no one would ride that would cost Ohio taxpayers millions of dollars annually?” he asked. “It’s a slam dunk.” -AP

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