Ohio Gov. John Kasich has dismissed state Treasurer Josh Mandel’s concerns about Medicaid expansion. The governor, a Republican, suggested opponents of Medicaid expansion are ill-informed.
“Oh, I don’t make too much of it. I mean, it’s a complicated issue,” Kasich said at a February 14 press event. “You know, it’s sort of like the school funding, right? I mean, everybody was hyperventilating when they saw the printouts, and then it settles down.”
Responding to questions about fellow Republican Mandel’s February 11 letter—thus far the clearest opposition to Medicaid expansion publicly expressed by a state-level Republican official—Kasich dismissed concerns Mandel expressed about the costs of the entitlement expansion.
“The Medicaid issue is something people need to look at carefully. There’s gonna be—look, it’s a complicated issue,” Kasich said. “It took us months to really unravel all of it, and I made a decision, and I don’t worry about people chirping about it. It’s just part of the process.”
No Personal Attack
Asked whether he felt Mandel understood Medicaid expansion, Kasich demurred, saying, “I’m not going to get into a battle with Josh here.”
“I haven’t read the letter, but I think it’s about, you know, the overall health—long term—of Medicaid,” Kasich added. “I was the chairman of the budget committee that balanced the budget. I understand Medicaid. Is that program going to need to be reformed in the next decade or so? Yes, but we have an issue today, and so it’s why we have in our proposal that if the federal government starts changing all the rules, we won’t continue to be in the program. I think it’s very reasonable.”
Kasich then reiterated, “I will tell you though, it’s complicated, and you have to look at it from a lot of different aspects.”
Alternative Path Was Wiser
Joseph Antos, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute, said Kasich should have considered other alternatives, and described several. For example, “[Wisconsin Gov.] Scott Walker’s approach, which reduces eligibility for Medicaid to 100% [of the federal poverty line] and sends those above that line to the exchange, makes more sense from a state perspective,” he said.
The state of Arkansas has also developed an arrangement, approved by the Department of Health and Human Services, which would put all newly eligible Medicaid recipients instead into the taxpayer-subsidized health insurance exchange.
“Another approach is to hold off and try to negotiate a better Medicaid deal with the White House, one that gives the state more control over Medicaid without having to go back to CMS for every little change in the program,” Antos added. “Perhaps the best approach is for the states to hold off on Medicaid and have Republicans pass a bill that gives states more complete control in exchange for a predictable budgeted amount for each Medicaid beneficiary.”
Kasich Administration Looked to Left
Prior to Kasich’s Feb. 4 announcement of his decision to implement a central piece of President Obama’s Patient Protection and Affordable Care Act (PPACA) by expanding Medicaid, free-market think tanks Opportunity Ohio and the Buckeye Institute for Public Policy Solutions both issued statements opposing the expansion.
Meanwhile, news reports and press materials on the governor’s website have revealed the Kasich administration worked with the Universal Health Care Action Network of Ohio, a socialized-medicine lobbying group, to form the public relations message about the governor’s Medicaid expansion decision.
Asked whether the Kasich administration contacted her for input, Galen Institute President Grace-Marie Turner said, “No, regretfully, they did not.”
“Governors are missing an incredibly important opportunity if they agree to expand Medicaid without first demanding reform of this expensive, cumbersome, outdated program,” Turner said. “One of the tragedies of passage of [PPACA] is that millions more people were added to Medicaid without reforming what is the worst health care program in the country.”
The Republican governors of Pennsylvania, Wisconsin, Iowa, North Carolina, South Carolina, Oklahoma, Texas, Idaho, South Dakota, Louisiana, Mississippi, Alabama, and Georgia have all refused to enact the PPACA Medicaid expansion in their states.