Kill, don’t delay, Ohio House vote on Medicaid override

Regardless of its motivation, the Ohio House of Representatives acted prudently last week in delaying any possible override vote of Gov. John Kasich’s veto of a freeze on Medicaid expansion in Ohio.

Whether that motivation stemmed from uncertainty over having the sufficient number of GOP votes to negate the governor’s justified veto or from political pragmatism over ongoing health-care debates in Congress as Ohio House leaders suggested, the immediate threat to 500,000 Medicaid expansion recipients in the state has at least temporarily been nipped in the bud.

The proposed freeze was included in the recently adopted $65 billion biennial budget for the state’s 2018 and 2019 fiscal years as a means to rein in state spending, even though the federal government covers the bulk of the expansion’s cost. The freeze would have prevented new lower-income adults from enrolling in Medicaid starting July 1, 2018, and anyone who dropped off the rolls at that point would be unable to re-enroll.

It therefore would have cruelly kicked to the curb the vast majority of Medicaid expansion recipients in the state who gained health-care opportunities for the first time, leaving some of our state’s neediest and most vulnerable residents in dire straits.

As a means to avert such merciless scenarios, Kasich divorced himself from Republican Party dogma and compassionately vetoed the measure June 30. We commended the governor for that bold action in this space last week.

Now, regardless of how the Medicaid debate plays out in Congress, the Ohio House should recognize the value of the program and make its temporary override-vote delay permanent.

As things stand now in Washington, ending federal Medicaid expansion, a key tenet of the Affordable Care Act repeal effort, looks to be headed nowhere fast. As of Tuesday, at least 10 Republican U.S. senators – including Sen. Rob Portman of Ohio – have indicated they will not support the Senate bill in its current form with its big hit to Medicaid and the 74 million Americans who benefit from it.

“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.

Given that the upper chamber of Congress can afford to lose only two GOP votes to keep its long-heralded goal of repealing Obamacare in its entirety alive, prospects look increasingly dim for deep retrenchments in the federal government’s commitment to the Medicaid health-insurance program anytime soon.

VALUE, IMPACT OF EXPANSION

For any doubting Thomases in the Ohio House and Senate about the value of the program, we would direct them to the 50-page Medicaid Group VIII Assessment report prepared for the General Assembly in December 2016 by the state Department of Medicaid. Group VIII is the name given to all who have gained eligibility for Medicaid under the expansion implemented in Ohio by the governor and against the Legislature’s wishes in 2014.

That report concluded that for Group VIII enrollees, “access to Medicaid has facilitated access to care, reduced emergency department utilization, improved self-reported health, and supported employment and job-seeking.”

The positive dividends of expansion have dramatically affected the Mahoning Valley. Mahoning County, for example, ranks first among all 88 Ohio counties in the percentage of all adult residents enrolled in the Group VIII Medicaid program at 14.4 percent.

In raw numbers, that translates into 20,292 additional Medicaid eligible recipients in the county. Trumbull County has 15,426 expansion enrollees and Columbiana has 6,670, according to May 2017 data from the state Department of Medicaid.

Given the Valley’s unemployment and poverty rates, which continue to far surpass state and national averages, now is not the time to pull the plug on the program and the tens of thousands here who stand to potentially benefit from it in the future.

Killing the vital program would not only hurt individuals but state and local economies as well. To be competitive, Ohio must possess a skilled and healthy workforce. Subjecting tens of thousands of Ohioans to the prospect of no health insurance would make our state all the weaker in the eyes of potential job creators.

We hope our elected representatives in the Ohio General Assembly and the U.S. Congress recognize as much and thwart this and any other oncoming attacks on Medicaid, the largest and most vital health-care program for the less fortunate in our nation.