The benefits of Medicaid expansion in Ohio are beyond question, from dramatically reducing the number of uninsured to providing millions of dollars to combat the state’s opioid epidemic. More than 700,000 Ohioans – 59,406 of them in Hamilton County – get insurance through the expansion under the Affordable Care Act, and the state cannot go back to when many of these people did without health care because it was too expensive.
That’s why the editorial board strongly supports Gov. John Kasich’s action in vetoing the freeze on Medicaid expansion proposed by Republican lawmakers in the state budget bill. We also oppose any efforts to override that veto. Freezing Medicaid expansion would essentially kill the program for many lower-income adults and put Ohio’s neediest citizens in more peril.
Kasich’s administration estimates that 500,000 people will lose Medicaid if the required three-fifths of the General Assembly votes to overturn the governor’s veto. The Ohio House could vote on the matter Thursday. While not everyone will lose coverage – those with substance abuse problems, mental illness or those who stay below the prerequisite federal poverty level will not – far too many Ohioans who now have regular access to treatment and care would be hurt.
The freeze would prevent new lower-income adults from enrolling in Medicaid starting July 1, 2018, and anyone who dropped off the rolls at that point would be unable to re-enroll. A lot of people jump on and off Medicaid each year as their monthly income fluctuates or because of seasonal employment. This measure would essentially end the program for them.
Cutting these citizens off is not only unfeeling and ill-advised, it is flat out wrong. For Ohio to be strong economically and attract business and jobs, the state must be able to provide not only a skilled and educated workforce but a healthy one as well. Eliminating access to affordable health care for thousands of Ohioans only promises to lead to more neglected conditions, a sicker population, more uncompensated care for providers and increased medical debt for the uninsured. That makes Ohio weaker, not stronger.
Republican lawmakers’ concerns about reeling in the state’s biggest expense in Medicaid and the uncertain future of health care in Washington, D.C. are understandable, but there must be more measured, compassionate and bipartisan ways to tackle them. Some Republicans have said that overriding Kasich’s veto would send a message. But the only message it sends to the thousands of citizens impacted is that GOP lawmakers care more about party politics than serving the public good.
Our message to the state legislature: Leave Medicaid expansion alone.
Unlike the effort to restrict Medicaid, the editorial board supports the bipartisan compromise worked out by the House and Senate that would have restored sales tax revenue to the state’s counties and transit authorities that had been cut off by the federal government. Federal regulators put an end to a tax structure that allowed Ohio to apply sales tax on services provided through Medicaid managed-care organizations to take advantage of federal matching funds. This same structure allowed counties and transit authorities to also benefit through their piggyback sales taxes. To offset this significant revenue loss, state legislators from both parties fashioned an alternative – increasing a state health insurance franchise fee for six years.
The compromise was another of the 47 items Kasich struck down with his line-item veto authority. Without it, Hamilton County would stand to lose $15 million a year that it uses for basic services and to help cover the county’s debt for the riverfront, stadiums and Union Terminal.
With many parts of the state still recovering from the Great Recession, now is the wrong time to be taking money away from already cash-strapped counties. Republican and Democratic lawmakers should come together and vote to override this Kasich veto.