This week, Ohio Governor John Kasich’s administration asked the seven-member Ohio Controlling Board to appropriate federal Obamacare funds for the purpose of Medicaid expansion, bypassing the state legislature.
The Obama administration approved Ohio’s request to amend its Medicaid program so that people making up to 138 percent of the federal poverty level ($32,499 for a household of four) would be covered. The state’s Medicaid director, John McCarthy, submitted the request Sept. 26 with a corresponding request for the Controlling Board to appropriate the federal funds without the approval of the Republican-controlled legislature, which has stalled Kasich’s plans for Medicaid expansion.
The Controlling Board consists of the chairs of the Senate and House Finance Committees (currently Republicans) and a Republican and Democrat from both houses. The director of the OMB (a Kasich appointee) serves as the board’s president. Generally, the board’s duties include transferring funds between line items or fiscal years, allowing for emergency funding, and approving grants and loans made by the Department of Development. There is speculation that the two Democrats and the Kasich appointee would vote for the Medicaid expansion, so Kasich would only need to secure one additional Republican vote to win approval from the board. Senate President Keith Faber, a Republican, said he believes Kasich has the authority to turn the decision over to the Controlling Board. “I’m certainly a defender of legislative rights, and I would think a better solution would be a legislative option, but the governor does have that authority,” he said.
However, questions remain about the authority of the board. The Ohio Revised Code prohibits the Controlling Board from carrying out any action “which does not carry out the legislative intent of the general assembly.” But Kasich spokesman Rob Nichols justified the action, saying, “Only the General Assembly can authorize Medicaid to spend funds in this way, either through a bill or the Controlling Board.” Kasich, vacationing in Europe, was not available for comment, the Dispatch reported.
Despite Kasich’s heavy-handed lobbying and arm-twisting on behalf of Medicaid expansion, the Republican legislature stripped the provision from Kasich’s biennial budget and has failed to act on his demands to expand the program to an estimated 270,000 additional Ohioans.
In 2011, Ohioans overwhelmingly voted for a ballot initiative to pass the Ohio Healthcare Freedom Amendment, designed to protect citizens from the Affordable Care Act. Despite vocal opposition from Tea Party groups and many other conservative groups in the state, Kasich has continued to push for the expansion, collaborating with a variety of progressive groups to promote the measure. Amy Brighton, co-founder and co-coordinator of Medina Tea Party Patriots, said, “Obviously, the idea of a representative government doesn’t mean anything to Kasich and his Administration, since they are seeking to intentionally defy the will of Ohioans who overwhelmingly voted to pass the Healthcare Freedom Amendment in 2011.”
Kasich’s aggressive move to force Medicaid expansion without legislative approval comes as Republicans are working on reforms to existing programs to help the uninsured in the state. On Thursday, Senate Republicans unveiled a Medicaid reform plan that would increase oversight, contain costs, and improve outcomes for patients. House Republicans have said they are working on more fiscally responsible plans to reform existing programs in order to better serve those without access to medical services.
But Greg Moody, director of the Governor’s Office of Health Transformation, stressed the urgency of the situation. “To be able to get this done by Jan. 1, we are at the point where we do need to act now,” he said.
Rep. Ron Amstutz, chairman of House Finance and Appropriation Committee, released a statement critical of Kasich’s move to subvert the legislature.
“I have grave concerns about the place, the time and the substance of this proposed Controlling Board action,” Amstutz said. “Based on our solid track record of passing tough bills, I would expect a far superior and more creative solution by legislative enactment than what I fear may result from effectively crimping the legislative process.”
Amstutz, a leading candidate to replace term-limited House Speaker William Batchelder, has worked through the summer and in the early days of the legislative session on plans to reform the state’s medical care for the poor.
Brighton, from Medina Tea Party Patriots, said this decision could hurt Kasich’s re-election chances. “It’s interesting that Kasich would succumb to Pelosi-esque tactics to implement Medicaid expansion,” she said. “After forcing the healthcare law on the American people, Pelosi and the House Democrats faced electoral consequences. I guess Kasich is willing to take that chance.”
Kasich defeated Democrat Ted Strickland in the 2010 election by two points — 77,000 votes. That year, the Libertarian Party candidate garnered 92,000 votes, or two percent of the total. In 2014, a third-party candidate may play the spoiler for Kasich if he continues to lose support from the conservative base in a state where 57% of Republicans voted for conservative candidates and 10% voted libertarian in the 2010 Republican primary.