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Ohioans earning less than 138 percent of poverty — $15,415 a year for an individual and $31,809 a year for a family of four — would be eligible for health coverage under Medicaid. Newly eligible Ohioans will soon be able to enroll through their local Department of Jobs and Family Services office or online at benefits.ohio.gov. House Republicans are considering a lawsuit challenging the board's authority to vote against the "legislative intent" of the General Assembly. Coverage would be delayed while the decision is tied up in the courts.
Ohio became the 25th state to expand Medicaid on Monday after a controversial 5-2 vote by a little-known legislative panel. Critics are already vowing to challenge the vote in court.
The Ohio Controlling Board, composed of six state lawmakers and one appointee of the governor, approved a request to release $2.56 billion in federal dollars and add an estimated 366,000 Ohioans to the Medicaid rolls.
Springfield Republicans Rep. Ross McGregor and Sen. Chris Widener joined Democrats Sen. Tom Sawyer of Akron and Rep. Chris Redfern of Catawba Island and Randy Cole, appointed by the Ohio Office of Budget and Management, in approving use of federal funds. Sen. Bill Coley, R-Liberty Twp. and Rep. Jeffrey McClain, R-Upper Sandusky, objected to the request. In advance of the vote, House Speaker William Batchelder of Medina, subbed in McGregor and McClain for two anti-expansion House Republicans said to be vying for the speaker post.
The panel’s approval only lasts for the time period funds were requested, through June 2015. For the expansion to continue, lawmakers must write it into law or state officials would have to file another request of the Controlling Board again.
Gov. John Kasich praised the approval in a statement: “Together with the General Assembly we’ve improved both the quality of care from Medicaid and its value for taxpayers. Today’s action takes another positive step in this mutual effort. I look forward to continuing our partnership with the General Assembly to build upon the progress we’ve already made to make Medicaid work better for Ohioans.”
State officials requested federal permission and dollars to enroll Ohioans earning less than 138 percent of poverty — $15,415 a year for an individual and $31,809 a year for a family of four – in Medicaid. Federal officials have pledged 100 percent of the cost for the first three years of expansion, gradually reducing its contribution to 90 percent over time.
Many of the newly eligible have jobs that do not provide health care nor pay enough for them to afford to buy insurance on the new health insurance exchanges. Expansion was a piece of the federal Affordable Care Act.
Expansion has drawn support from a diverse group of organizations including the Ohio Chamber of Commerce, Ohio Hospital Association, Ohio Right to Life and faith groups. Medicaid serves 2.4 million Ohioans, most of whom receive care through privately managed plans such as CareSource.
Pam Morris, president and CEO of CareSource, praised the decision.
“The investment made to help individuals and families take responsibility for primary and preventative care reduces the cost of uncompensated care,” Morris said in a statement. “When we invest in people the benefits return to our communities through robust economic development.”
The controversial vote is expected to trigger lawsuits from conservatives who say Kasich did an end-run around the General Assembly to enact a major, flawed policy change. Maurice Thompson, executive director of the 1851 Center for Constitutional Law, said plaintiffs, including some House Republicans, would be finalized by Tuesday.
Republican lawmakers rejected Kasich’s proposal to expand Medicaid in the state budget earlier this year and inserted language into the budget explicitly prohibiting expansion. Conservatives were concerned the federal government won’t hold its end of the bargain and Ohio will be on the hook for the full cost of expansion.
Kasich used his line item veto power to strike that language, leaving language intact that allows the state to expand to any group not prohibited by law.
Thompson said the full vote of the General Assembly carries more weight and the last-minute member switch makes the maneuver look more illegitimate.
“What it also should show a court… is the need for a full legislative consideration of the issue and for strict judicial oversight over such bodies that can be ends oriented instead of means oriented,” Thompson told reporters after the vote.
Widener said he supported expansion primarily because it will cover an estimated 26,000 veterans. Widener said he lobbies for Wright-Patterson Air Force Base and it seemed hypocritical for turn his back on those veterans now.
“These people are not wanting to be on Medicaid their whole entire lives,” Widener said. “They’re working Ohioans, they’re Ohioans who need help for a little time related to a health care issue.”
He made it clear that the Controlling Board approved the funding request but the Ohio Medicaid Department expanded the program by seeking approval from the feds.
Widener plans to introduce a bill returning the money saved from expansion, an estimated $404 million, to taxpayers in the form of an across-the-board income tax cut.
McGregor told the Columbus bureau that he would have preferred the General Assembly approve expansion but he supported going through the Controlling Board. McGregor called expansion “the right thing to do.”
“I hear what my colleagues say when they say people should go get a job,” McGregor said. “It’s just not that easy. It really is not that easy.”
Ohio Medicaid Department Director John McCarthy said newly eligible Ohioans will be able to enroll for coverage through the online portal at benefits.ohio.gov soon, but not as soon as Tuesday.
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