On Wednesday, 39 House Republicans responded to John Kasich’s decision to take his proposed Medicaid expansion to the State Controlling Board for approval. They filed a letter of protest, arguing that the maneuver circumvents the “clear intent” of the legislature and violates state law.
Expect a lawsuit to follow, if the governor prevails at the seven-member Controlling Board on Monday.
William Batchelder, the House speaker, signed the letter. He acknowledged a lawsuit is “possible.” He also said something curious, as reported in the Columbus Dispatch: “It’s obviously where one house of the General Assembly is, and obviously also not a majority. I think there were 30-some signatures so there may be less here than meets the eye.”
Does that mean there is a House majority for the Medicaid expansion, among the remaining Republicans and Democrats? One disappointment has been the lack of a simple vote on whether to extend health coverage to 138 percent of the poverty level, 275,000 Ohioans benefiting directly, the federal government paying 100 percent of the tab for three years and ultimately 90 percent going forward.
Batchelder may not have had as trying of a week as his fellow speaker, John Boehner. He did face similar crosscurrents within his party.
At times, it wasn’t pretty. How else to describe Batchelder signing the protest letter and then diminishing its significance? Add that news reports suggest he is ready to switch House members on the Controlling Board, providing the governor with the support needed for the expansion.
Currently, the six legislative members of the Controlling Board break down to four Republicans and two Democrats. The seventh member represents the governor. Thus, the mix translates into three likely votes for the expansion, requiring one Republican to join the governor’s side.
The speculation has been that state Sen. Chris Widener will be the one, the politically attuned noting that a vote for expansion would trigger less of a stir back home in Springfield. Why would Batchelder aid the governor at the Controlling Board? Members of his caucus who favor the expansion would avoid any prospect of having to put their support on the record in separate legislation and risk a primary challenge.
Striking in all of this are the echoes of the debacle on Capitol Hill involving the debt ceiling and the government shutdown. Many Republicans lawmakers are determined to thwart the Medicaid expansion, recognizing that it plays a crucial role in making the Affordable Care Act work. For instance, hospitals and insurers are counting on the new customers to help with the bottom line.
On Saturday, the New York Times shed light on the nationwide effort of Americans for Prosperity and other arch conservatives to block Medicaid expansion in states. Would the 39 protesting Ohio lawmakers, including Marilyn Slaby, Christina Hagan and Kristina Roegner from the Akron area, find success in court?
The past eight months, or since the governor unveiled his proposal, Republicans in charge of the Statehouse have played a delay game — their intent plain. The budget they sent to the governor removed his plan and barred an expansion of Medicaid.
Their problem is, the story doesn’t stop there. The governor vetoed the item with the prohibition. More, the budget actually contains language authorizing the state Medicaid director to move on the expansion. As the law firm of Vorys, Sater, Seymour and Pease explains in an analysis, lawmakers have opened the door for the director to seek federal approval of a State Plan Amendment to expand Medicaid eligibility.
John McCarthy did just that, receiving approval two days before the governor’s announcement, $2.5 billion in federal Medicaid money now available for the state.
Vorys adds that lawmakers long ago gave the Controlling Board authority “to increase an existing appropriation when the state receives additional funds.” Federal stimulus dollars traveled through the board. So did Race to the Top money.
States have much leeway in shaping their Medicaid programs. They have options in extending eligibility. What Ohio lawmakers have not done is enact a law blocking coverage for those people newly eligible under the Affordable Care Act.
For his part, the governor isn’t above expedience. On Thursday, kasichforohio.com sent an email message urging supporters to sign a petition calling for a constitutional amendment that would mandate a balanced federal budget. “America has a skyrocketing national debt, and it is simply not sustainable,” the message goes. “If our leaders don’t act quickly to rein in the size of government, we’re crushing future generations with a massive financial burden.”
And the source of that money for the Medicaid expansion?
As a matter of policy, the governor has it right. The proposed expansion of Medicaid has wide support, many recognizing the benefit to the state economy and the quality of so many lives. He also heads to the State Controlling Board on firm legal ground.
Consider the majority he seeks there. It looks much like the one already on hand at the Statehouse, bipartisan, Democrats and a fewer number of Republicans backing the expansion. You could say the board reflects legislative intent.
Douglas is the Beacon Journal editorial page editor. He can be reached at 330-996-3514, or emailed at firstname.lastname@example.org.