Medicaid rolls will continue expanding in Ohio, as the state’s House of Representatives declined to vote on whether to override Gov. John Kasich’s line-item veto of legislation that would have frozen enrollment in the Obamacare Medicaid expansion.
The Ohio General Assembly approved $132.8 billion for the state’s biennial 2018–2019 operating budget on June 28, 2017. The bill would have blocked new enrollment in the state’s Medicaid expansion under the Affordable Care Act, except for those being treated for mental illness or drug or alcohol addiction, Cleveland.com reported.
Kasich vetoed the Medicaid expansion freeze on June 30. The House of Representatives overrode several other line-item vetoes in a special session on July 6. A vote to override the veto of the Medicaid expansion freeze did not come to the floor.
Kasich had predicted Ohio’s Medicaid expansion program would cost $13 billion by 2020, but program costs already exceed $13.5 billion, Ohio health care policy researcher Jason Hart wrote in an op-ed for National Review on July 6.
Growing Concern
Rea Hederman, executive vice president and chief operating officer of The Buckeye Institute, says enrollment is already nearly twice as big as expected.
“Under the Medicaid expansion in Ohio, the program was originally projected to grow to 440,000 by 2020 but has well exceeded that estimate and currently stands at more than 700,000,” Hederman said.
State Rep. Nino Vitale (R-Urbana) says Ohio’s Medicaid program is overwhelming the state budget.
“Medicaid is becoming the single biggest explosion to the state budget and will soon be eating into all other services, like education and roads,” Vitale said. “It’s just a matter of time.”
Medicaid invites misuse, prompting enrollees to drive up costs to the taxpayer, Vitale said.
“There are no incentives or skin in the game for people to use the social program prudently, so they go to the emergency room when they should be seeing their general doctor during normal office hours,” Vitale said. “The Ohio House has done a fiscal disservice to the people of Ohio by not taking up this issue and reining in this program.”
Reverse Triage?
State Rep. Wesley Goodman (R-Cardington) says Medicaid expansion prioritizes able-bodied patients over more vulnerable people.
“Freezing enrollment in Obamacare’s Medicaid expansion is the most impactful thing that Ohio can do to rein in an out-of-control program that is putting Ohio’s most vulnerable citizens at risk,” Goodman said. “Rather than investing our limited resources on the truly needy—like poor and disabled children—we are enrolling hundreds of thousands of able-bodied, childless adults into a welfare program.”
Hederman says Kasich’s veto diverts state funding from the patients who need it most.
“The Medicaid freeze would give the state the opportunity to focus care on the sick and most needy, and we are hopeful that the General Assembly will continue its work to reform the Medicaid program,” Hederman said.
‘Missed an Opportunity’
State Rep. Paul Zeltwanger (R-Mason) says the House abandoned its post by failing to override Kasich’s veto.
“I was disappointed that we did not have the collective will to override the governor’s Medicaid expansion freeze [veto],” Zeltwanger said. “Budgets require financial discipline and tough decisions, and we missed an opportunity to take a first step in proactively managing out-of-control Medicaid costs.”
Medicaid expansion penalizes students and people with mental illness, Zeltwanger says.
“Prioritizing able-bodied single adults over mentally ill or K-12 education funding is poor public policy,” Zeltwanger said.
Not Over Yet
Goodman says the legislature may override the veto after all.
“As we continue to talk to our constituents over the summer who are negatively impacted by Obamacare, I am confident that we will return in the fall to complete our work and override the governor’s veto,” Goodman said. “And while stopping expansion enrollment is incredibly impactful, we have already taken important steps to put guard rails around the system that provide real reforms to the Medicaid program.”
The legislature is trending away from Medicaid expansion, Goodman said.
“Whether it’s reasserting legislative control over setting rates and eligibility, creating work requirements, or using Controlling Board authority to ensure greater executive compliance, we have already shown a willingness to begin to move away from the governor’s flawed direction of the Medicaid program through overriding nearly a dozen Medicaid-related vetoes,” Goodman said. “This fall, that work will continue.”
David Grandouiller ([email protected]) writes from Jamestown, Ohio.
Official Connections:
Ohio state Rep. Wesley Goodman (R-Cardington): http://www.ohiohouse.gov/wesley-a-goodman
Ohio state Rep. Nino Vitale (R-Urbana): http://www.ohiohouse.gov/a-nino-vitale
State Rep. Paul Zeltwanger (R-Mason): http://www.ohiohouse.gov/paul-zeltwanger
Image via Thinkstock
