John Kasich remains a picture of patience — on expanding Medicaid. The governor talks about taking state legislative leaders at their word about addressing the health-care program for the poor and disabled when lawmakers return next week from their long summer recess. He understands the value of gaining legislative consensus on something so controversial.
Yet, ultimately, actions are most telling. So far, William Batchelder, the House speaker, and Keith Faber, the Senate president, have been architects of delay, inviting the impression they really aren’t interested in joining the governor in expanding Medicaid, bringing reliable health coverage to an additional 270,000 Ohioans. They have pushed back their own deadlines. On Tuesday, the speaker again voiced concern about the federal government reneging on part or all of its commitment.
What the speaker doesn’t say is that the worry already has been eased. The governor’s proposal contains language allowing the state to back off if the feds fail to keep their word.
Practically speaking, such a sequence of events isn’t going to happen, the governor among those offering assurances, and he knows more than a thing or two about how the federal budget works.
Read the actions of Batchelder to this point, and the governor is smart to explore alternative ways of expanding Medicaid. He alluded last week to a concept much discussed around the Statehouse, gaining approval of the expansion through the State Controlling Board. He pointed to the potential “to get this done through somewhat of the normal processes and procedures that are permitted here.” He spoke to reporters about working “in conjunction with the legislature.”
The Controlling Board fits the description. It has seven members, six of whom are state lawmakers. The remaining member represents the governor through the Office of Budget and Management. The board serves as a mechanism for making adjustments to the state budget. Thus, the rough thinking is that the board could approve the influx of federal dollars necessary to expand Medicaid, adding coverage for those up to 138 percent of the poverty level.
Past practice indicates the authority exists for the board to act. This is how the state has handled the arrival of federal Race to the Top money for public schools. Federal stimulus funds flowed through the board. Worth stressing is that the Medicaid expansion initially involves all federal dollars, the feds covering 100 percent of the cost for the first three years (and 90 percent thereafter).
There is another alternative. On Thursday, Healthy Ohioans Work gained certification to launch its petition drive to put the question of Medicaid expansion before voters next year. The expansion has broad support. So it makes sense to pursue a ballot issue. The advantage of the Controlling Board is the opportunity to move quickly — to meet the Jan. 1 start of expanded eligibility.
You would think Democrats would rally to the concept, with two members on the Controlling Board, or halfway to a majority, and so many in the party supportive of the expansion. Yet state Rep. Chris Redfern, the state party chairman, expressed skepticism to the Cleveland Plain Dealer last week. To be sure, it would be better to go through the legislature. Yet if the door is closed, seek the best available alternative route. Medicaid expansion is too important to let the opportunity slip.