Kasich Continues Hedging on Medicaid Expansion

Ohio Governor John Kasich insisted during the August 2 edition of the conservative Coffee and Markets podcast that he has not “taken a stand” against Obamacare and has not decided if Ohio will comply with the law’s called-for Medicaid expansion. Asked about his plans for expanding Medicaid eligibility, Kasich replied, “I’m not sure yet.”

The governor, a Republican, expressed skepticism that the federal government will cover states’ Medicaid expansion costs as promised, saying, “when it comes to Medicaid expansion the government tells me, ‘well, we’ll pay 90% and you pay 10.’ Well I’ve been in Washington, unfortunately, and today it’s 90 and tomorrow it’s 80 and the next day it’s 70.”

One aspect of the June 28 Supreme Court decision considered a win by conservatives gives governors the ability to reject Obamacare’s Medicaid expansion without sacrificing current federal Medicaid funding.

However, rather than acknowledge that national debt is approaching $16 trillion and flatly refuse to expand Medicaid eligibility, Kasich said, “I’ve instructed my staff to begin to talk to Democrat and Republican staff members for governors to see if there’s a way that we can carve something out here.”

In a June 28 press call, Ohio Medicaid Director John McCarthy said, “we haven’t come close to getting $369 million in savings” that could be used to cover the estimated cost of new Medicaid enrollment under existing eligibility rules. McCarthy added that the administration expects a $675 million annual spike in state Medicaid spending by 2018, assuming Obamacare’s individual coverage mandate takes effect as scheduled in 2014.

Both McCarthy and Lt. Governor Mary Taylor – who is also director of the Ohio Department of Insurance – strongly suggested Ohio will not be able to afford the new costs imposed by anticipated Medicaid enrollment increases from currently-eligible individuals forced to enroll to avoid Obamacare fines.

During the same call, Taylor said, “clearly, the governor and I are opposed to Obamacare period, and we believe the best solution is for it to be repealed and to give states the flexibility to deal with these kinds of issues in the way that’s best for each state.”

While neither explicitly stated Ohio will not expand Medicaid eligibility during the June 28 call, no reasonable interpretation of their statements could lead to another conclusion.

Taylor has been a consistently vocal critic of Obamacare. In a September 28, 2011 press release, she wrote, “There is a staggering price for every American attached to providing ‘free’ or subsidized health care coverage.  At a time when our country is $14 trillion in debt and when states are making hard choices to balance their budgets, this law is going to cause an explosion in health care spending never before seen.”

The national debt has since increased by nearly $2 trillion.

According to the Kasich administration’s own estimates, Ohio will struggle to comply with Obamacare’s mandates under current Medicaid eligibility rules. It seems odd that Kasich, who has a reputation for speaking bluntly, hesitates to firmly oppose expansion of a program that is already too expensive.

A transcript of the relevant conversation from the August 2, 2012 edition of Coffee and Markets follows.

C&M: “We obviously know that you’ve taken a stand against the implementation of Obamacare in your state, the implementation of it in the form of–”

Kasich: “No, I haven’t yet, no, I haven’t taken a stand.”

C&M: “Well, I wanted to ask about the Medicaid expansion. What’s your thoughts on that, and do you think that it’s something that–”

Kasich: “I don’t, I’m not sure yet. I’m not sure yet. I mean, the biggest problem that I have is that – forget the expansion – just the fact that it has now been declared the law of the land, I’m going to have a $950 million increase in my costs, without any expansion. So the minute I get out of an $8 billion hole I now face a billion-dollar cost that I didn’t have before John Roberts came out with his decision.

Now, when it comes to Medicaid expansion the government tells me, ‘well, we’ll pay 90% and you pay 10.’ Well I’ve been in Washington, unfortunately, and today it’s 90 and tomorrow it’s 80 and the next day it’s 70. Plus, there is tremendous inflexibility with the Medicaid program. Ya know, you’ve gotta climb Mt. Kilimanjaro to get the federal government to give you a waiver to implement something that will serve your people better. So I’ve instructed my staff to begin to talk to Democrat and Republican staff members for governors to see if there’s a way that we can carve something out here.

Because, ya know, what you wanna do is cover as many people as you possibly can, make sure people have health insurance, but, ya know, ‘trust me’ from the federal government doesn’t feel real good to me. We’ll see.”

C&M: “In terms of the fiscal burden it would put on Ohio, are you still running those numbers to sort of see, you know, long term even at that 90% rate what the cost would be for you guys?”

Kasich: “Ya know, everybody wants to spend their time talkin’ about expansion, why don’t we talk about the problem we currently have, which is a billion-dollar hole. So, ya know, I’m gonna deal with that before I think about expansion.”

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