John Kasich Wards Off Ohio Lawmakers' Attack on Medicaid Expansion

by | July 7, 2017

By Jim Provance

The Ohio House on Thursday handed Gov. John Kasich the first veto overrides of his administration, but it did not attempt to undo his veto of a budget provision to freeze enrollment in the Medicaid expansion he's fought to defend.

Mr. Kasich had exercised his line-item veto authority 47 times last week before signing the $65 billion, two-year budget into law, and the chamber, sometimes with Republicans and Democrats working together, overrode 11 of them.

One of the those overrides is designed to give counties and some public transit authorities six more years to prepare for the loss of more than $200 million a year in revenue from a now defunct tax.

Other overrides affected Medicaid rates for providers and nursing homes, attempts to rein in Medicaid costs, and limits on the power of the quasi-legislative Ohio Controlling Board.

The controlling board provisions are in direct reaction to Mr. Kasich's use of the board in late 2013 to use the panel to draw down billions of federal dollars to launch the Medicaid expansion over the objections of many of his own party in the General Assembly.

But the most controversial Kasich veto, one in which he again thwarted fellow Republicans, will stand, at least for now. That provision would have required his administration to seek federal permission to freeze enrollment into the controversial Medicaid expansion.

The Affordable Care Act currently pays 95 percent of the tab for those who earn up to 38 percent above the federal poverty level to qualify for government-supplied health coverage.

If the federal waiver were granted, enrollment would have been frozen as of July 1, 2018. Anyone already in the program at that time would continue to be covered. But, with the exception of the mentally ill and addicted, no one else could enter the program after that date, and anyone who drops off because of eligibility issues that later change would not be able to re-enroll.

The Kasich administration has suggested that 500,000 could ultimately lose coverage as a result. The program currently serves about 725,000, far more than was originally expected when the governor enacted the program three years ago.

House Speaker Cliff Rosenberger (R., Clarksville) left the door open to revisit the issue in September. There is no firm deadline for action other than the end of the legislative session nearly a year and a half from now.

He insisted he had the 60 votes for an override if he had brought it to a vote.

"At this juncture, we want to give the summer to let the federal government see if they're going to come to a conclusion in Congress before we take action moving forward with the freeze waiver request," he said.

The chamber voted 87-10 to override the governor's veto of the General Assembly's managed-care tax replacement language.

The federal government nixed the state's gimmick in which they used a sales tax on managed-care organizations doing business with Medicaid to raise state funds that were leveraged to draw down even greater federal funds to spend on Medicaid.

The Kasich administration has replaced the tax with a new franchise fee on all managed-care companies, Medicaid and otherwise. That will take care of the state's $500 million-a-year revenue problem, but it doesn't provide a permanent solution for counties and public transit authorities that levy piggyback sales taxes.

The General Assembly added a provision requiring the administration to seek federal permission to raise the amount of the fee for six years to continue replacement funds for the local entities. The Kasich administration had planned to provide partial replacement of the money for two years, but then those dollars would end.

"They have enjoyed the revenue for six years," Rep. Bill Seitz (R., Cincinnati) said. "They should enjoy the revenue for another six years...They will not get a full replacement..., but they will get substantial reimbursement if our request to the federal government is granted...

"Our counties are the administrative arms of the state," he said. "We depend on them to provide local jails, the court system, the probation system, the job and family service system, the child support system, the indigent defense system. We cannot leave our partners in the dust."

The sole negative vote from northwest Ohio belonged to Rep. Derek Merrin (R., Monclova Township).

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