More than two thirds of the Ohioans insured under the Affordable Care Act are covered by the law’s optional Medicaid expansion, according to figures released by the U.S. Department of Health and Human Services.
A total of 234,507 Ohioans have selected a private insurance policy through the federally run exchange at HealthCare.gov, while as of the end of January the number signed up through the state’s Medicaid expansion was 492,121. For every Ohioan choosing an exchange plan, two have enrolled in the Medicaid expansion.
“These figures undermine any claim by John Kasich that he did not support Obamacare, as two times as many people enrolled in his Medicaid expansion as in the exchange,” said Matt Mayer, president of the free-market think tank Opportunity Ohio.
Medicaid Expansion Dominates
Because Medicaid reimbursement rates to care providers are so low, nearly 40 percent of Ohio State Medical Association doctors surveyed last year said they planned to accept fewer Medicaid patients in 2015.
Ohio Medicaid beneficiaries currently pay no premiums, and — assuming they can find a doctor — they receive the same “minimum essential benefits” Obamacare requires for policies sold at HealthCare.gov.
The exchange offers premium subsidies to Ohioans whose income is between 100 and 400 percent of the federal poverty line. Medicaid expansion coverage extends to 138 percent of the poverty line.
HHS figures are also inflated by including individuals who choose an exchange plan but never pay a premium, and also include those who were previously insured. A June 2014 survey by the Kaiser Family Foundation suggested that nationally, only 57 percent of exchange enrollees were previously uninsured, suggesting that only around 133,000 Ohioans have actually gained private coverage under Obamacare.
Kasich Supporting Obamacare?
Kasich, a Republican, says he is against Obamacare and supports its repeal. However, his implementation of the Obamacare Medicaid expansion has been a huge win for the president’s unpopular 2010 health insurance law.
President Obama has pointed to Kasich as an example for all Republicans to follow, and insists the biggest problem with Obamacare is the refusal of 22 states to expand Medicaid.
Federal funding for the expansion is set to drop from 100 percent to 95 percent in 2017, and has already been targeted for cuts by the president and Congress. At current spending and enrollment, Kasich’s Medicaid expansion would cost state taxpayers $30 million per month by 2020. In Ohio alone, Medicaid expansion cost federal taxpayers $2.1 billion last year.
In 2010, Kasich complained that Medicaid expansion would “stick states with large and unsustainable costs.” But seeking billions per year in new federal funding, Kasich opted to implement the Medicaid expansion in 2013 and circumvented the Ohio General Assembly to do so.
Kasich has argued Ohio’s rejection of the Obamacare Medicaid expansion would send “Ohio’s tax dollars” to other states, and claims the Medicaid expansion isn’t part of Obamacare.