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Ohio House may revisit Kasich Medicaid veto


    Ohio Gov. John Kasich vetoed a budget provision June 30 that called for freezing new Medicaid expansion enrollment starting July 1, 2018, and preventing those who drop off the program from re-enrolling.

COLUMBUS, Ohio >> The Ohio House today was again weighing an override of Republican Gov. John Kasich’s veto protecting Medicaid expansion after scrapping the idea in July.

A memo circulating among House Republicans said GOP Speaker Cliff Rosenberger “would just like to see” where his caucus members stand now that efforts to repeal the federal health care law in Washington appear indefinitely stalled. The memo, obtained by The Associated Press, gave a reply deadline of 5 p.m. Sunday but added: “This does not mean the veto override will be on the floor this week.”

Kasich vetoed a budget provision June 30 that called for freezing new Medicaid expansion enrollment starting July 1, 2018, and preventing those who drop off the program from re-enrolling.

The 2016 presidential contender has been one of the most vocal champions nationally within his party of the expansion. He argues it should be viewed as distinct from the Affordable Care Act that made it possible, a law Republicans tried but failed to repeal and replace earlier this year.

In a dramatic faceoff with a same-party governor, Rosenberger’s chamber reconvened days after the veto appearing poised to call an override vote. But, while 11 other vetoes were overridden, the vote on expansion never came. Without House action, the Ohio Senate also could not act.

Rosenberger said at the time that his chamber had the 60 votes necessary to override the veto. He said the vote didn’t go forward because Republicans wanted first to give more time to see how the national health care debate would play out. According to the memo, GOP state representatives discussed the issue again at this week’s caucus meeting.

Some 700,000 low-income adults are now covered under Ohio’s expansion, at a cost of almost $5 billion — most of which is picked up by the federal government. The Kasich administration has estimated that 500,000 Ohioans could lose coverage under a freeze within the first 18 months.

The memo lays out a strenuous case against expansion — including by reviving some arguments disputed during the original debate.

Lawmakers are told that, if they override the veto, coverage would still be available under Medicaid expansion for those diagnosed with mental illness or drug addiction.

The Governor’s Office of Health Transformation has said the federal government will not allow Ohio, or any state, to serve one specific group and not others so, the state contends, either all those eligible will keep cover or lose it.

Ohio receives some $300 million through the program for drug addiction and mental illness, which Kasich has described as an important funding source for a state hard hit by the national opioid crisis.

House leaders are clearly concerned about cost, describing Medicaid spending as “out of control” in the memo. The document points to enrollment that exploded under the expansion after Kasich made his initial end-run around lawmakers to adopt it. While his initial enrollment estimates were around 447,000 participants, 725,000 Ohioans have signed up.

The administration counters that Medicaid spending, the largest portion of Ohio’s state budget, has come in under budget by a combined $3.6 billion the past two fiscal years.

The document also raises concern about the potential reduction of the enhanced federal match received by states that took advantage of the expansion.

Republicans in Washington propose a lower match as they envision efforts to rein in Medicaid’s overall costs. However, their inaction has left in place Ohio’s current 90 percent match for now.

Kasich has said he would move to end expansion if a new deal is offered to states that Ohio can’t afford. He has been working with Colorado Gov. John Hickenlooper, a Democrat, on a bipartisan fix to the national health care law.

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