While Hillary Clinton says she’ll protect President Obama’s health insurance law and Donald Trump promises, frankly, a terrific surprise replacement, one Republican governor is traveling the country promoting Obamacare’s Medicaid expansion.
Gov. John Kasich lent Obamacare advocates a hand last week when he visited Texas to talk about what a great decision it was to expand Medicaid in Ohio.
Speaking at the Texas Tribune Festival in Austin, Kasich said “Obamacare doesn’t work,” only to brag moments later about being “one of the first ones to get out and expand Medicaid.”
Texas is one of 19 states where lawmakers have refused – despite Obama’s insistence that all Republicans should follow Kasich’s example – to implement Obamacare’s expansion of Medicaid to working-age adults with no kids and no disabilities.
Before Obamacare, Medicaid eligibility was restricted to pregnant women, children, the elderly, the disabled, and impoverished families. Medicaid expansion includes no work requirements, and there’s no limit to how long enrollees can remain on the program.
In Ohio and nationwide, most of Obamacare’s enrollment is a result of Medicaid expansion.
Kasich dislikes Obamacare, he told the Austin crowd, because its mandates on insurers, employers, and individuals are “top down.” But the same is true of Medicaid expansion, which uses new federal spending to provide coverage defined by the feds to anyone who meets federal enrollment guidelines.
Rehashing a standard from his presidential stump speech, Kasich said the question he had to ask himself when embracing Obamacare was, “Do I wanna help 400,000 Ohioans and can I manage Medicaid to the point where I’m not gonna break the bank?”
Before Kasich expanded Medicaid, he said the expansion would enroll nearly 450,000 people and cost $13 billion by 2020. Data from Kasich’s own Department of Medicaid have proven those estimates wildly inaccurate, but Kasich keeps touting his outdated, disproven projections.
Kasich also said last week that he slowed Medicaid spending growth in Ohio “from like 10 percent to 2 percent without cutting anybody off the rolls,” another campaign trail boast.
In his last budget, Kasich recommended reducing Medicaid eligibility for pregnant women and women with breast or cervical cancer from 200 percent of the poverty line to 138 percent. If the Ohio General Assembly hadn’t rejected it, this proposal would have cut traditional Medicaid recipients from the program at the same time Obamacare expansion was adding working-age, able-bodied, childless adults.
When Kasich took office in 2011, Ohio’s Medicaid program cost state and federal taxpayers a total of $17.7 billion. Since then, annual Ohio Medicaid spending has rocketed to $25.5 billion – a 44 percent increase, fueled by the 700,000 adults Kasich added under Obamacare.
Kasich’s Obamacare expansion has already cost more than $9 billion – about twice as much as expected. That hasn’t stopped the governor from encouraging other states to make the same mistake.
“You can see how many governors now are trying to do this very thing but just calling it by another name,” Kasich said during his Texas Tribune Festival keynote. “Which is ok with me.”
Ohio pays for 38 percent of its traditional Medicaid benefits, an out-of-control portion of the state budget even before Kasich expanded the program. Obamacare expansion is completely paid for by the feds until next January, when the state share of costs gradually begins to increase to no more than 10 percent – a perverse incentive Kasich brags about falling for.
Imagine a state needs to plug a $100 million hole in its budget, and can save $1 with every $10 of Obamacare expansion cuts or $3.80 with every $10 of cuts to traditional Medicaid. How many legislators will care that traditional Medicaid enrollees are the truly needy the program was meant to serve?
If Clinton plans to build on a health law whose mandates and exchanges have been a mess from day one, Medicaid expansion is the foundation she’ll start from. Trump says he wants to repeal Obamacare, but Trump also advocates single-payer socialized medicine nearly every time he talks about health policy.
Terrible presidential candidates make it all the more important for states to resist promises of federal money as a cure-all. Ohio has failed in that regard, and will be on the hook for a growing share of more than $4 billion in Obamacare expansion costs every year.
A governor willing to own his mistakes would be trying to save his state from an exploding welfare expansion whose promised companion “reforms” are already rubble. John Kasich is not that governor.
And if you thought you were freed from Kasich’s hugs & unity schtick by his withdrawal from the GOP primary this spring, think again. Sometime Democrat consultant John Weaver is still advising Kasich, who is setting groundwork for 2020 as we speak.