Ohio Democrat and former Obama appointee Rich Cordray is running for governor on friendly policy turf, with Republicans arguing over how gently they should reform outgoing governor John Kasich’s Obamacare Medicaid expansion.
Kasich, a Republican, made news last week by refusing to endorse Republican nominee Mike DeWine, warning that DeWine could ruin the massive federal handout that is the cornerstone of Kasich’s legacy. DeWine, who has offered to request federal waivers to make Medicaid expansion “sustainable and affordable” instead of committing to end the program, was the most pro-Obamacare candidate in the Republican primary.
Cordray – trying to frame DeWine’s call for changes to a four-year-old welfare program for able-bodied, working-age adults as an attack on the poor – capitalized on Kasich’s remarks with a campaign video defending Medicaid expansion and JobsOhio, Kasich’s secretive, publicly-funded job creation agency.
“Governor Kasich recently said he’s worried about two issues, Medicaid expansion and JobsOhio,” Cordray said. “So, this message is for Ohioans who agree with Gov. Kasich: I am your candidate.”
“I will protect Gov. Kasich’s Medicaid expansion,” Cordray promised, claiming that DeWine wants to end it.
Meet the new boss…
For all his protestations otherwise, it’s been obvious for five years that Kasich supports Obamacare. By endorsing DeWine in February, Ohio Republican Party leaders signaled that their attachment to the law’s new Medicaid spending won’t end in January when Kasich hits his term limit.
Before DeWine became Ohio’s attorney general, he was one of the most liberal Republicans in the U.S. Senate. Before the May 8 primary, DeWine flooded the state with print and television ads labeling his opponent an Obamacare supporter, yet during a June 2017 interview he said that putting 700,000 Ohioans on Medicaid under Obamacare “has done a lot of good.”
“We don’t want that to go away. That’s very important,” DeWine told Toledo news channel WTOL less than a year ago, highlighting the benefits drug addicts receive via Medicaid expansion. If DeWine continues to talk tough about restraining Medicaid spending – which has skyrocketed under Kasich – his WTOL interview will feature in every Cordray ad until November.
Kasich gave Cordray another boost during a press conference this week, saying he would vote for DeWine but again refusing to endorse the Republican nominee without assurance that he’d keep Medicaid expansion in place. “I want people who are mentally ill and drug addicted to get what they need,” Kasich said.
Since he unilaterally expanded Medicaid in 2013, Kasich, like DeWine, has made treatment for heroin and prescription opioid addiction the chief justification for his decision. But the expansion took effect in January 2014, and Ohio’s drug overdose death rate climbed by 59 percent from 2014-16.
In 2016, fewer than four percent of Obamacare expansion enrollees were diagnosed opioid abusers, and less than six percent of the program’s $4.7 billion in costs were spent on addiction treatment. The Kasich administration hasn’t released more recent addiction treatment data, and both his Department of Medicaid and Office of Health Transformation have failed to reply to public records requests.
If DeWine were to look beyond the rhetoric from hospital lobbyists and their favorite governor, maybe he wouldn’t fight as ferociously as Kasich has to keep Obamacare expansion place. Cordray, meanwhile, must be thrilled that Kasich has smeared Obamacare critics as extremists while he shifts ever further left on health policy, making it easy for Democrats to do the same.
As governor, DeWine would have no power to implement the Medicaid block grants he says he supports, but in 2016 Kasich ran on block-granting Medicaid if elected president. The only specific change to Medicaid expansion that DeWine is campaigning on is a work requirement the Kasich administration has already asked the Trump administration to approve.
Although estimates of the work requirement’s impact vary, 200,000 enrollees could lose eligibility and there would still be more Ohioans on the new welfare program than Kasich projected would sign up by 2020. Five years ago, zero expansion enrollees were eligible for Medicaid.
Cleaning up Kasich’s mess
Instead of trying to tweak an Obamacare program that will cripple the state’s ability to pay for education, infrastructure, public safety, and health benefits for the truly needy, Ohio should freeze Medicaid expansion sign-ups, said Nic Horton, research director for the free-market Foundation for Government Accountability.
“The way to make sure Medicaid is sustainable for those that truly need it is to move as many able-bodied adults out of the system as possible, as quickly as possible,” Horton told Hot Air.
“Particularly under ObamaCare expansion, Medicaid has gotten off track and become an open-ended entitlement for able-bodied adults who could and should work,” Horton added. “Policymakers who are serious about fixing the system should focus their efforts on providing a path out of welfare for able-bodied adults.”
If a few more Ohio General Assembly members were willing to stand up to Kasich, the Republican-supermajority legislature could have overridden his veto of a Medicaid expansion freeze last year. Their proposal included an exemption for addiction treatment, and current enrollees could have remained on Medicaid until their income climbed above Obamacare’s eligibility limit.
DeWine may be forced to choose between signing or vetoing a Medicaid expansion freeze as governor. At least one candidate for speaker of the scandal-wracked Ohio House wants to end the Obamacare expansion, and the president of the Ohio Senate is open to another attempt at freezing enrollment after Kasich leaves office.
One way or another, lawmakers will have to address the staggering cost of Kasich’s Medicaid expansion: a total of $16.8 billion from 2014-17, monthly spending averaging $456 million in 2017, and a state share of $20 million per month and climbing.
That’s not to say Kasich has no answer for the cost of his new welfare program doubling his projections… in January, his administration stopped disclosing Obamacare expansion spending in its monthly reports.