Wind energy, poor Ohioans among budget losers
How far away from an Ohioan’s property line must a wind turbine be? House Republicans have signaled they think turbine setbacks should be specified in a standalone bill, not as part of the 5,000-page state budget the legislature sent Gov. John Kasich last week. But trying to use the budget bill to kick 700,000 low-income Ohioans off Medicaid? No problem.
That’s the “heads we win, tails you lose,” angle in this year’s Statehouse budget debate. The mere idea of generating power from wind or the sun seems to rile Capitol Square’s Flat Earth Caucus. But some other science is evidently good science. Yank Medicaid from poor Ohioans? Hey, maybe that Darwin guy had the right idea about survival of the fittest.
Wind energy wasn’t the only topic the budget ducked. Both chambers cried the blues about lagging state revenues, but wouldn’t tighten, better yet, end, a lush tax break (the Business Income Deduction) that costs Ohio’s treasury $1 billion a year. And whatever you think, pro or con, about how, and with how much or how little money state government helps fund K-12 schools, you can only patch a tire so many times. Legislators keep slapping on patches anyway.
Footnote: By the time this column appears, Kasich likely will have announced his line-item budget vetoes, vetoes that might address or even junk some of the budget provisions that follow. (To overturn a veto, the Ohio House, 66-33 Republican, would have to muster 60 override votes, the Senate, 24-9 Republican, 20 override votes.) Still, what follows are the decisions legislators did indeed make last week:
The as-passed budget’s central problem: How the House and Senate approached Medicaid. They budgeted Ohio Medicaid this way: They assumed the Kasich administration would achieve “x” dollars in Medicaid savings. But then legislators in effect made it impossible for Kasich’s administration to attain those savings without slashing some Medicaid providers’ payments. For example, according to the Office of Health Transformation, nursing homes (and Medicaid pays about 70 percent of all Ohio nursing home costs, a Legislative Service Commission analysis reports) are the only Ohio Medicaid provider group whose reimbursement rates are guaranteed by the Ohio Revised Code. The budget didn’t change that. So, other Medicaid providers would face steep payment cuts.
Then, effective July 1, 2018, the budget bill proposed freezing Ohio’s Medicaid expansion. It covers about 700,000 Ohioans. Legislators exempted from the freeze mentally ill or addicted Ohioans. Problem one: Exempting a subset of people from the freeze might not be legal. Problem two: Medicaid clients cycle on and off the program, depending on income, jobs, etc. If, during a freeze, an expansion client left Medicaid, then qualified to return (because of, say, a layoff) she or he couldn’t again actually regain Medicaid expansion coverage.
Throwing 700,000 Ohioans off the Medicaid expansion wouldn’t really be a budget plus. The federal share of Medicaid for most nonexpansion Ohio Medicaid clients is 63 cents per $1 in costs. But for Ohioans covered by the expansion, the federal share is 95 cents per $1 in costs. (The federal share gradually drops to 90 cents in 2020, where it’ll remain.) And a “provider tax” Ohio charges Medicaid providers likely makes Ohio’s 5-cent bite per $1 in the Medicaid expansion’s costs a gain for the state.
Meanwhile — yes — no matter what flat-earth legislators think, generating electricity from wind could be an economic boost for Ohio. A small-is-beautiful suggestion: Put a turbine at the front of the Ohio House chamber. Old-time reformers are believed to have called it the House of Wind. It still is.