A proposal to freeze enrollment under Ohio’s Medicaid expansion was gaining traction Friday as a way to secure enough conservative support to get the state budget through the Ohio House.
The move once again appeared to be pitting the state’s Republican-controlled state Legislature against GOP Gov. John Kasich, who made an end-run around skeptical lawmakers in 2013 to push through the expansion allowed under the federal health care overhaul.
Kasich has remained an outspoken advocate at the state and national levels for the expansion, which now covers nearly 720,000 Ohioans.
It was not immediately clear how the proposal might impact state funding for drug addiction and behavioral services, even as the House GOP has set tackling Ohio’s opioid epidemic as its top budget priority.
A potentially substantial portion of the $650 million federal match Ohio receives annually through Medicaid for drug addiction and behavioral services could be jeopardized by the freeze. Nearly 500,000 low-income adults have been treated for mental health and addiction through Medicaid benefits extended to the working poor.
The loss in federal matching funds could exceed the $170 million earmarked for a host of drug treatment, education, outreach and rehabilitation initiatives in the House version of the budget.
House Finance Chairman Ryan Smith, of Bidwell, said the financial ramifications of supporting the freeze are being studied. He said he expected the freeze to be discussed at a meeting on the budget Saturday.
“It’s on a few people’s lists,” Smith said. “I think it’s important to a number of members.”
The $66 billion, two-year spending blueprint is set for a House vote next week.
The freeze amendment was proposed by freshman state Rep. Wes Goodman, a Cardington Republican. It calls for prohibiting any new enrollees to Medicaid who qualify through the federal Affordable Care Act, commonly known as Obamacare. Current enrollees could stay on the program until they became ineligible or until Congress acted to reduce the federal match, whichever came first.
State Rep. Larry Householder, a Republican former speaker who supports the freeze, said Ohio must rein in its Medicaid spending before it swallows the budget.
“With the Obamacare Medicaid expansion, what we’re doing is taking people (into the program) up to 138 percent of poverty level,” he said. “With Medicaid being such a huge issue in our budget, our answer can’t be to put more people on.”
He’s behind another proposed budget amendment that would allow the state to seek a waiver so it could negotiate Medicaid changes tailored to the state’s needs, he said.
Americans for Prosperity-Ohio state director Micah Derry said the free market group supports the freeze and the waiver as a means of driving down health care costs. He challenged suggestions that capping an entitlement program would be unconstitutional and could ultimately sink the expansion altogether.
Derry said the Goodman amendment “is primarily a messaging tool to show Washington there’s support in the state” for a freeze and the waiver would allow flexibility to renegotiate aspects of Ohio’s health care market.
“At the end of the day, the governor’s on a book tour and we’ve got a budget hole to fix,” he said.
Kasich is traveling the country promoting “Two Paths: America Divided or United,” a reflection on his experience as a 2016 presidential contender.
Spokesman Jim Lynch said the governor is actively engaged in the budget process.