Kasich and GOP legislators should avoid Medicaid standoff

It’s good to hear that Ohio Gov. John Kasich is ready to fight for the expansion of Medicaid coverage for the state’s residents and that he is confident that he’ll win the battle.

Kasich told the Cincinnati Enquirer a few days ago that he believes providing broader Medicaid coverage is “a matter of life and death,” and that it is not a matter of if the expansion is going to happen, but when.

The certainty with which Kasich has been talking about the Medicaid expansion is somewhat surprising, given that he is taken on the Republican majority in the General Assembly, especially the House of Representatives. But it is no less surprising than his appearance earlier in the month at a pro-expansion rally at the Statehouse that was more Democratic than Republican in character and attendance (although the governor has the backing of the Chamber of Commerce on the issue as well).

Kasich’s support for expanding Medicaid coverage in Ohio under President Obama’s Affordable Care Act makes sense on every level except that of ideology.

The state has the opportunity to expand Medicaid coverage to families with incomes up to 138 percent of federal poverty level (about $15,400 per person or $23,050 for a family of four). That would extend Medicaid to about 300,000 men, women and children, and it would bring billions of federal dollars into Ohio each year — about $13 billion over seven years.

During the budget debate, Republican legislators said the state couldn’t afford to eventually pay its 10 percent share of the cost, yet they unilaterally suggested spending about $300 million in the two year biennial budget on a much more limited expansion of health care in the state. Why not leverage that money to bring billions more into the state to help hundreds of thousands of more people? The only answer is that Republican legislators want to make an anti-Obama, anti-federal government statement.

Costs vs. Benefits

But it will be the people of Ohio who will be paying for that statement in numerous ways.

Fewer people will receive treatment. Fewer doctors, hospitals, pharmacies and nursing homes will receive payments, and fewer employees of all of those entities will receive paychecks. And to the extent that some of those 300,000 uncovered Ohioans have to seek treatment for which they can’t pay at hospital emergency rooms, the costs will be passed along to other Ohioans and companies that provide health care coverage for their employees.

Kasich and GOP leaders in the House and Senate should be working out their differences in August so that legislation can be passed allowing the state to take advantage of the opportunity the Affordable Car Act provides.

Come September, if no agreement is reached, Kasich is going to have to begin playing hard ball or be seen as a Republican governor who couldn’t get his own party to work for the benefit of the state and its people.

Faced with a similar standoff, Arizona’s Republican governor, Jan Brewer, began vetoing Republican bills that came across her desk until the Legislature relented. She came out the winner, but neither Kasich nor General Assembly leaders in Ohio should want to see Ohio’s Medicaid standoff come to that.