Ohio will forgo $13 billion in federal aid over the next seven years that would have paid to provide health care to thousands of uninsured Ohioans under a budget plan House GOP leaders will unveil today, The Dispatch has learned.
Facing immense pressure from tea-party-affiliated groups, Republican leaders will strip Gov. John Kasich’s proposed Medicaid expansion to cover 275,000 adults without health insurance, with the entire cost paid by the federal government under Obamacare for three years. It also would have saved Ohio taxpayers $400 million over the next two years.
Instead, Republicans will propose providing $50 million a year in state funds for mental health and addiction services, according to multiple sources.
House leaders will unveil their substitute two-year budget this afternoon after Republican members meet privately in the morning.
Supporters of the Medicaid expansion question the move, noting that lawmakers will forgo billions in federal aid and spend additional state tax dollars to prevent thousands of uninsured Ohioans from gaining coverage.
“Investment in mental health and addiction services is both great and needed, but not a substitute to an extension of health care coverage. What does that do for the uninsured patient with a lump in her breast? Or the uninsured veteran with high blood pressure who faces far worse health outcomes, potential hospitalization or worse, if left unmanaged?,” said Julie DiRossi-King, director of government affairs for the Ohio Association of Community Health Centers.
“If Ohio chooses not to expand Medicaid, we are going to be left with serious gaps in coverage and also with real life scenarios where someone (making) 200 percent of (the federal) poverty (level) will be able to access coverage through the exchange but a woman who is 50 years old with grown children working part time and at 95 percent of the poverty level will have nothing.”
Republicans also rejected an alternative plan that, if approved by federal regulators, would have set up a three-year pilot program in which Medicaid funds would have been used to purchase private insurance coverage for the expansion population.
Last week, Rep. Anne Gonzales, R-Westerville, who headed the finance subcommittee on human service issues, said she was concerned about the governor’s plan and using the federal money for private insurance because of the lack of certainty from the federal government.
“We have a trillion-dollar deficit. It’s a concern that we are continuing to add more debt,” she said.
Jon Allison, leader of the Ohio Alliance of Health Transformation, a coalition of community organizations, businesses groups, health care providers and religious organizations pushing for the Medicaid expansion, said more than 1,000 people plan to rally at the Statehouse on Thursday as efforts continue to try to get some type of expansion approved before a House vote next week.
Groups will continue to make phone calls and emails to lawmakers and testify in committee, Allison said.
“From our perspective, it was always critical that the governor’s Medicaid proposal, maybe not exactly how he proposed it, needed to pass the House because our likelihood of success in the Senate is a question mark,” Allison said.
The feeling among supporters is that, politically, the Senate would have a hard time stripping the Medicaid expansion out of the budget if the House approves it. Conversely, they know that considering some recent critical statements from Senate President Keith Faber, R-Celina, they will have a tough time getting the GOP-dominated Senate to add the expansion if the House strips it out.
Allison, a former chief of staff for Gov. Bob Taft, said it’s a tough issue for House Republicans, and he has heard a number of them express concerns about the size of the federal deficits and the mistrust of the federal commitment to the expansion. A handful also is being influenced by tea party primary election threats, he said.
“Unfortunately, for enough members of the House Republican caucus, it’s coming down to politics over people,” Allison said.
Rejecting the federal money, he said, means a number of people, including thousands of veterans, will continue to go without health coverage, a number of small employers could pay penalties under the federal health care law. He said a trigger in Kasich’s expansion plan, or the proposed three-year pilot program floated by some House Republicans, are two good ideas to protect Ohio if the federal government doesn’t fulfill it’s promises.
“As a lifelong Republican, I absolutely respect genuine concern about our nation’s deficit,” Allison said. “But what can a state legislator really do to fix something that Congress and the president is unable to fix?”
He added: “Like it or not, the Affordable Care Act is the law of the land. Barack Obama was re-elected and there’s no ability in Congress to change this. Because we don’t have perfection, are elected officials really going to throw this all out?”
Sources indicated that about 40 House Republicans said they would vote to support the Medicaid expansion, far short of the 50 needed to pass the plan contained in Kasich’s two-year budget plan. With Speaker William G. Batchelder of Medina among those opposed to the expansion, it became very difficult to win additional votes.
A number of House Democrats support the Medicaid expansion, but few, if any, are expected to vote for it as part of Kasich’s overall $63.3 billion two-year budget.
By Catherine Candisky and Jim Siegel - The Columbus Dispatch, Ohio (MCT)
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