William Batchelder has come up with every excuse to block expanding Medicaid in Ohio. Mostly, the House speaker has talked vaguely about “uncertainties” and “lack of clarity” regarding implementation of the Affordable Care Act and “what it means if they [Washington] don’t have the money” to support the proposed expansion. Batchelder and his caucus are sworn to repeal the federal health-care law and to do all they can to obstruct it in the meantime. If the Republicans’ decision to strip Medicaid expansion from the House budget bill thus is not entirely a surprise, it still is a galling rejection of a critical opportunity to advance health care in the state.
John Kasich took the option of Medicaid expansion not as a fan of the reform law. He was convinced, after extensive studies, that an expansion will significantly enhance the state’s economy and health-care system. Indeed, considering the effort the governor and his health-care team have put into restructuring Ohio Medicaid, his Republican critics cannot very well argue he is not mindful enough of the state’s obligations and finances in proposing the expansion.
The House Republican caucus has focused on costs, skeptical of the federal government’s promise to carry between 100 percent and 90 percent of the coverage for the newly eligible. What Batchelder and friends largely ignore, unfortunately, are the well-documented benefits in the equation.
An estimated 275,000 poor and uninsured Ohioans stand to gain coverage. Across the state, support for an expansion is broad and strong, hospitals, social service providers, chambers of commerce and insurance companies have found rare common cause in pointing to the many advantages of coverage for the poor: Ohio has the opportunity to improve individual and public health. Coverage will reduce significantly the expense of unpaid and uncompensated services, which increase the cost of health insurance premiums for everyone. Within a restructured and more efficient Medicaid system, Ohio stands a better chance of controlling costs through managed care.
House leaders tout the additional funds in their budget for mental health and addiction services. That is commendable, to be sure. Again, an expansion offers no less. Studies show federal dollars from Medicaid expansion directed to mental and behavioral health care — say, for inmates or people with a dual diagnosis of mental illness and addiction — not only would release local funds that could then be applied to other services but would give patients a fair shot at productive lives.
House leaders have left some wiggle room, hinting of continued discussions as the governor’s office negotiates for flexibility with federal officials. With the Senate yet to take up the budget bill, the hope is legislators will reverse a decision so clearly detrimental to the poor and the rest of Ohio.