Kasich's Administration Split on Implementation
Although Ohio is party to the 26-state lawsuit questioning the constitutionality of President Obama’s health care law, an internal split has developed within Republican Gov. John Kasich’s administration concerning implementation of the law.
Lt. Gov. Mary Taylor, who heads the Ohio Department of Insurance, has described the law as “catastrophic.” But appointee Greg Moody, who leads the state’s Office of Health Transformation, has spoken positively about some aspects of it.
“All of this is more complicated than an easy yes or no,” Moody said in an interview with Gannett. “There are aspects of federal reform … that picked up innovation on the state level. Those are things we were going to do with or without” the federal law.
Taylor, by contrast, reiterated the administration’s opposition to the law.
“The Governor and I oppose the federal health care law and want to see it repealed and replaced with something that works better for individuals and businesses by fostering a vibrant health insurance marketplace, reducing costs and fighting lawsuit abuse,” Taylor said in an official statement. “We are seeking every possible option to reduce costs for job creators and help Ohioans preserve control over their health care. Ohio continues to study the best path forward and has not made any decisions.”
John Graham, director of health care studies at the Pacific Research Institute, says Ohio lawmakers should avoid undermining public opposition to the law.
“The state is giving a mixed message and threatens [to impede] the defeat of Obamacare if it collaborates in any way,” said Graham.
Although Taylor has reiterated her opposition to the federal law, she has also said Ohio is still evaluating the chief question facing the states, whether to implement the insurance exchange mandated by Obama’s law, Graham notes.
“Implementation of Obamacare is not a goal toward which state officials should be working,” Graham said. “Instead, they should do their best to stifle Obamacare, until the Supreme Court or the November 2012 election defeats it. If [those events] do not result in the defeat of Obamacare, there will be plenty of time for states to respond to the law.”
Greg Lawson, a policy analyst with the Buckeye Institute, says Ohio has not been as adamantly against Obama’s law as some states and has accepted a few federal taxpayer-funded grants related to implementation.
“I think [Lt. Gov. Taylor’s] concerns are federal mandates and aspects of how it’s going to create a whole cost vortex for Ohio,” Lawson said. “If the law is struck down, that opens up a whole new vista of what can happen. If upheld, we have to implement or the feds are going to come in. Nobody knows what’s really going to happen. There’s no stability yet.”
Implementing Budget Woes
If Ohio adopts any aspects of Obama’s law, budget woes will follow due to the expansion of Medicaid, Lawson says.
“It would be unquestionably negative for the state’s budget,” Lawson said. “Ohio is already dealing with a Medicaid budget referred to as the ‘Pac Man’ of the state budget by a former governor. The way the law is structured will open up the floodgates of more people being eligible for Medicaid.”
Medicaid currently represents 30 percent of Ohio’s state budget and is growing, Lawson notes.
“The whole thing is one big tightrope,” Lawson said. “What it’s been all along is joint federal-state funding. The feds always come in with the majority of the funding, but the state has to pony up as well. Obamacare really exacerbates the problem.”
Ohio Not Alone
This problem faces every state, says Graham.
“We’re going to see increases in the number of Medicaid recipients by 16 to 18 million people,” Graham said. “Although the federal government will borrow most of the money from the central bank of communist China to finance this expansion, states like Ohio will also be on the hook for much of the money.”
Graham says centralization is the main motivation behind Obama’s law
“Health care is local,” Graham said. “This law centralizes policy decisions that have traditionally been made by state legislators. The central government will impose policies with unintended consequences.