Kasich’s lasting legacy: Medicaid expansion
Governors leave legacies. Some are programs. Some are policies. And sometimes a legacy is how he (someday, she) campaigned to win the governorship, a job the Ohio Constitution says holds “the supreme executive power of this state.”
Republican John R. Kasich’s two-term governorship will end Jan. 14. And there’s a strong case to be made that Ohio’s Medicaid expansion, an incontestably positive move, which Kasich got done despite the opposition of some other Statehouse Republicans, will be seen as his lasting legacy.
All told, abut 663,000 Ohioans were enrolled in Medicaid expansion coverage in June. That’s about 41,000 fewer than were enrolled in July 2017.
Data marshalled by state Medicaid Director Barbara Sears and state Budget Director Timothy S. Keen supply evidence of Medicaid expansion’s statewide benefits.
First off, and just one example: Expansion has reduced the proportion of Ohioans who are uninsured. If that prompts a shrug, ask someone from your hometown hospital’s board or leadership about the cost of emergency room visits (costs to the taxpayer) by uninsured people as opposed to the costs of an office visit to a primary care doctor.
Then there’s this facet, highlighted by Keen’s Budget Office: “[Medicaid] expansion is a sig- nificantly better financial deal for [Ohio] than traditional Medicaid.” Reason: Because of budget offsets (costs averted, or revenues gained, because of the expansion). That means Ohio’s federally required 10 percent match for expanded Medicaid in the fiscal year ending in June 2021 (halfway into the next governor’s term) will actually net out at a 3.2 percent match, Keen said.
Moreover, there’s this telling facet: As of last November, Medicaid expansion clients (as a percentage of all adults ages 19-64) was ranged from 11.3 percent to 14.5 percent in counties that have suffered job losses in manufacturing, such as Clark (Springfield), Cuyahoga (Cleveland); Jefferson (Steubenville); Mahoning (Youngstown); and Trumbull (Warren).
But the same 11.3 percent to 14.5 percent range of Medicaid expansion enrollment also was true for a cluster of three east-central counties – Coshocton; Guernsey (Cambridge); and Muskingum (Zanesville) – and in a dozen counties south of Columbus, from Fayette (Washington Court House), Hocking (Logan) and Ross (Chillicothe), on south to the Ohio River.
Republicans represent all 15 of those east-central and southern counties in the General Assembly. And Republicans run Ohio’s House 66-33 and the state Senate 24-9. Both of those majorities are vetoproof. Some of those legislators have groused about Medicaid expansion. But neither the Ohio House nor the state Senate has overturned Medicaid expansion because Republican state legislators know how much Medicaid expansion benefits their General Assembly districts.
That hasn’t kept some Ohio Republicans from grousing that John Kasich is at best a marginal Republican because he expanded Medicaid coverage — hardly something a conservative would do. They might want to brush up on what “Mr. Republican” — the first Robert A. Taft (1889-1953), grandfather of Gov. Bob Taft — thought. The senator was a leading conservative, a key reason that the GOP’s Eastern Establishment repeatedly denied Sen. Taft the GOP’s presidential nomination.
Sen. Taft said this in a 1946 speech: “Those unable to pay for medical care undoubtedly fail to get it in many cases where it would be of substantial benefit to them ... We have always recognized the obligation of a government to provide free medical care to those unable to pay for it themselves.”
That is, although self-defined Statehouse conservatives may not know it, John Kasich, by aiming to assure Ohioans’ access to health care, is on the same page as Robert A. Taft.
Expansion has reduced the proportion of Ohioans who are uninsured . ... Ask someone from your hometown hospital’s board or leadership about the cost of emergency room visits (costs to the taxpayer) by uninsured people as opposed to the costs of an office visit to a primary care doctor.