COLUMBUS -- Ohio will expand Medicaid in January to as many as 330,000 people after the state board on Monday voted 5-2 to approve Gov. Johh Kasich's request, after a morning of drama in the Republican party.
Springfield Republicans Sen. Chris Widener and Rep. Ross McGregor joined the board's two Democratic lawmakers and Kasich's lone Controlling Board appointee in voting to accept federal money to expand Medicaid in Ohio. Sen. Bill Coley, R-Liberty Township, and Rep. Jeff McClain, R-Upper Sandusky, voted against Kasich's request.
With the vote, Ohio becomes the 25th state to agree to expand Medicaid under President Barack Obama's health care act. Kasich is the eighth Republican governor to oversee Medicaid expansion, much to the dismay of many in his party.
When Controlling Board President Randy Cole said the request had been approved, a sigh of relief rose from some of the 175 people packed into the state Senate building's ornate North Hearing Room. Dozens of them had stood through two hours and five minutes of board members' questions about the Medicaid request. Nearly 120 others listened to an audio feed of the hearing from the statehouse atrium.
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The vote was preceded by a Monday-morning standoff in the House Republican caucus. Speaker Bill Batchelder, R-Medina, had planned to put both a "yes" and a "no" vote on the seven-member board set to meet that afternoon. He wanted to substitute for the two regular members of his caucus, who both happen to be running to replace him as speaker, because of concerns that the controversial vote could affect that race.
But Rep. Ron Amstutz, R-Wooster and chair of the House Finance Committee refused to be absent as the board considers whether to accept federal money to expand Medicaid in Ohio under the Affordable Care Act. Wanting to keep things even for the speaker's race, Rep. Cliff Rosenberger, R-Clarksville, said he also declined to miss the meeting.
So Batchelder made permanent replacements for both Amstutz and Rosenberger. The state representatives both were expected to vote against Kasich's request. In their place are McGregor and McClain.
After Republicans in the Legislature declined to bring Kasich's Medicaid-expansion plan to the floor for a vote, Kasich this month announced he would seek permission to accept the money through the Controlling Board, made up of six legislators and one Kasich adviser. The governor's appointee and the panel's two Democrats were expected to support his proposal, leaving him in need of one vote from the GOP. In the end, he got two.
One of those votes was due to Speaker Batchelder's choice of new Controlling Board members, even though Batchelder had repeatedly said Ohio needed to "reform" Medicaid, not "expand it." Last week he and McClain joined 39 House Republicans, including all 11 state representatives from the Southwest Ohio delegation, in signing a protest saying Kasich's Controlling Board move is illegal.
Yet on Monday, Batchelder replaced Rosenberger, a "no" vote, with McGregor, a "yes" vote. The speaker's spokesman said he would release a statement later today explaining his decision to replace both of his caucus' Controlling Board members.
"I'm a little taken aback by it," said Rosenberger, saying the speaker originally asked him to miss the board meeting because he didn't want the speaker's race clouded by the Medicaid vote. "I had the same concerns as Representative Amstutz. If Representative Amstutz wouldn't (miss the meeting), nor would I."
Amstutz said he has no hard feelings against the speaker, who has the authority to replace Controlling Board members. But he's disappointed that Kasich is putting Medicaid expansion before the Controlling Board, changing course after months of trying to get the full Legislature to vote on the issue.
"There will be some relational problems here that are going to make it difficult to work together," Amstutz said of the Legislature and the governor's office, highlighting a divide in the GOP over Medicaid expansion. "It's just saddening that there was a level of impatience here."
Some of Kasich's GOP opponents say he is leading a charge to saddle taxpayers with the responsibility of paying for health care for hundreds of thousands of additional Ohioans.
"I think that we need to be controlling costs," McClain told The Enquirer Monday. "This is the federal example of just throwing billions at (a problem)."
In addition, the constitution lists the General Assembly, not the Controlling Board, as the state's only legislative body, the state representatives' protest letter said. And Ohio law prohibits the Controlling Board from going against "the legislative intent" of the General Assembly, which the lawmakers say they made clear in anti-Medicaid-expansion clauses passed in the state budget this spring.
Kasich continues to say Medicaid expansion is "just the right thing to do."
"The morality of a human being who's been blessed, helping a human being who has challenges, is a moral imperative in our lives. It just is," Kasich said last week of Medicaid expansion. He spoke of offering drug-addiction and mental-health coverage through Medicaid. "The ability to get our dollars back from Washington, to rehab these people and restore their lives, has to be done."
The state needs a few weeks to activate online enrollment via www.benefits.ohio.gov for the new population of potential Medicaid members. New members will start receiving coverage on Jan. 1.
Under the expansion, about 330,000 low-income adults without any option for subsidized insurace are newly eligible, according to the Kaiser Family Foundation, a group that analyzes health policy. That's the number of uninsured Buckeyes who are disqualified for coverage under the current Medicaid system and whose income is too low to qualify for federal tax credits designed to subsidize insurance on the new Obamacare exchanges.
Meanwhile, Kasich's expansion move will almost certainly to draw lawsuits, especially from conservatives wanting to argue against the legality of using the Controlling Board for what is essentially a policy decision. Medicaid supporters argue the Controlling Board has the authority to approve an increase in federal money for state agencies.
By: Chrissie Thompson/Cincinnati.com