Ohio Gov. John Kasich (R) has argued rejecting the Medicaid expansion authorized and paid for under the Affordable Care Act (ACA) would be a loss for the state’s taxpayers, claiming federal tax money paid by Ohioans would be spent in other states instead of coming back through federal matching funds.
According to the Congressional Research Service (CRS), rejecting the Medicaid expansion would not send Ohio tax dollars to other states.
CRS, a department of the Library of Congress providing policy guidance to members of Congress, answered questions about the ACA, also referred to as Obamacare, in a January memo published by the free-market think tank Foundation for Government Accountability.
“If a state doesn’t implement the ACA Medicaid expansion, the federal funds that would have been used for that state’s expansion are not being sent to another state,” CRS said in its memo. “There is not a set amount of federal funding for Medicaid.”
“The CRS memo is very important, as it highlights how Medicaid is actually structured—it is an entirely open-ended program with no defined limits,” said Greg Lawson, a policy analyst with the Buckeye Institute, in an e-mail to Ohio Watchdog.org.
“It is flat-out inaccurate to say our money will go to other states,” Lawson said.
Kasich has repeatedly described expanding the state’s Medicaid program as a way to bring tax dollars back to the state. Speaking to George Stephanopoulos on ABC’s Good Morning America in December 2014, Kasich said, “Now, on Medicaid expansion, I’m able to bring Ohio money back to Ohio. … Why wouldn’t I do that, George? That’s common sense to me.”
During his 2013 State of the State speech, Kasich said, “If we don’t do what we should do on Medicaid, they’ll be spending it in California.” Kasich called the expansion “an unprecedented opportunity to bring $13 billion of Ohio’s tax dollars back to Ohio to solve our problem.”
The CRS report explains the funding stream doesn’t work the way Kasich suggests it does.
“If a state hasn’t implemented the ACA Medicaid expansion, the state would not receive any federal Medicaid funding for the expansion,” CRS wrote. “However, this doesn’t mean any additional federal Medicaid funding would be allocated to states that have implemented the expansion.”
Each state’s Medicaid expansion is paid for with new federal spending. The nationwide cost of Medicaid expansion increases with every state that opts in.
“The Buckeye Institute made this case throughout 2013 during the Medicaid debate, and this report validates our position,” Lawson said. “The report undermines claims that if Ohio doesn’t expand Medicaid, it will lose tax dollars to other states.
“This reinforces the urgency of reforming Medicaid and getting recipients off of it as quickly as possible,” Lawson said. “Medicaid expansion in Ohio not only did not keep money in Ohio but instead ensured that Ohio citizens will eventually face higher taxes to pay for this program.”
The Kasich administration declined to respond to a request for comment on the memo.
Jason Hart ([email protected]) writes for Watchdog.org, where an earlier version of this article first appeared. Reprinted with permission.