By breathing new life into the issue of Medicaid expansion, Ohio House Republicans last week kept alive a debate that has split the GOP over whether to sign onto a federal promise for billions in new health care dollars.
In a budget amendment passed unanimously Thursday, Ohio House members took Medicaid expansion out of the state budget but bought time to consider alternatives. At stake is billions in federal funding under Obamacare that would pay to extend health insurance to 275,000 poor, working Ohioans.
The amendment, while short on specifics, would require some sort of action from the House before Dec. 31.
Bryan Bucklew, president and CEO of the Greater Dayton Hospital Association, said the move sets a solid timeline and expresses a willingness to explore alternatives, which both bode well for Medicaid expansion.
“Our concern all along is there might be different ways to take advantage of the Medicaid funds aside from a straight Medicaid expansion,” Bucklew said. “But we didn’t think a plan B should be just not to do anything and reject it in its entirety, which it appeared that a lot of people wanted to do. Having that amendment come out at least keeps the issue on the table.”
Gov. John Kasich, a Republican, had proposed extending Medicaid eligibility to 138 percent of the poverty limit, which works out to be about $21,000 a year for a family of four. The federal government would foot the bill for the first three years and then pay 90 percent of the costs, paying $13 billion over seven years.
Republicans in the House Finance Committee earlier this week scuttled Kasich’s plan, which had drawn threats of primary election challenges from tea party groups concerned over the expanding federal deficit and the overall implications of the federal health care law.
While the issue’s prognosis is still unclear, the lawmakers bought themselves more time to explore alternatives to backing away from the plan — and the federal money — entirely. The Medicaid language added Thursday sets a blueprint for a state-led plan, with a focus on helping people get jobs that take them off the Medicaid rolls. Ohio Medicaid officials would have to clear any reforms with the federal government before Oct. 1.
Chris Littleton, president of Ohio Rising, a group that spearheaded opposition to Medicaid expansion, said he’s glad the house separated the Medicaid debate from the overall state budget.
Littleton is also heartened by elements of the amendment that pledge to reduce the state’s health-care costs by transitioning people from Medicaid to private insurance plans, which he said offer better health outcomes.
“What we did not want to see happen is all this political pressure come to bear and force people to take this money that affects Ohioans for generations all on a short timeline of a few weeks,” Littleton said
Among the alternatives House Republicans will research includes a plan passed by the GOP-Arkansas legislature earlier this week. Under that proposal, which awaits federal approval, Arkansas would take the federal money intended for Medicaid expansion under Obamacare and instead use it to buy private insurance for low-income people.
Terry Russell, executive director of the Ohio National Alliance on Mental Illness Ohio, said the 11th-hour change gives him and other advocates for Medicaid expansion a foothold as the issue now moves before the Ohio senate.
“We were really grateful the door was left open. We weren’t sure that was going to happen as of Wednesday,” Russell said.
Staff Writer Jackie Borchardt and the Associated Press contributed to this report.