We are encouraged by the Ohio House’s recent decision to give authority to the Kasich administration to further explore Medicaid expansion options for the state. For nearly two months, hundreds if not thousands of individuals and organizations from across Ohio have advocated for the Medicaid expansion to be included in the new two-year state budget. There is much at stake for taxpayers, health-care providers, businesses and the broader community.
Gov. Kasich’s support for Medicaid extension is politically courageous. He knew he would likely face condemnation from the conservative press and Obamacare opponents inside the Washington beltway.
But instead of choosing the politically expedient option, the governor did what Ohio governors, whether Republican or Democrat, are elected to do. He looked at what’s right for the people of Ohio.
Under the health-reform law and last year’s Supreme Court ruling, every state now has the option to expand Medicaid to provide health insurance to hard-working, uninsured adults who make less than $15,400 a year or $32,000 for a family of four. Coverage may start as soon as January 2014.
Most of those who are likely to benefit are in our community. We encounter these individuals each day. They cut our hair. They serve us at restaurants. They are taking care of our preschool-age children and our aging parents. They serve as ministers in our local congregations. We know and love many of these people. They work hard and pay taxes.
The humanitarian case for Medicaid extension is powerful. Many facts can be arrayed in favor, but Gov. Kasich poignantly said it best: “For those that live in the shadows of life, those who are the least among us, I will not accept the fact that the most vulnerable in our state should be ignored.”
Moreover, the fiscal case is too powerful to ignore. Normally, the state and federal government share the cost of Medicaid. In Ohio, the federal government picks up 63.6 percent and the state treasury funds the rest. However, for the cost of those newly insured through Medicaid expansion, the federal government will cover 100 percent for three years and no less than 90 percent thereafter.
Over the next 10 years, the added federal funding means over $13 billion for Ohio, in addition to providing much-needed health care and supportive services to thousands of Ohioans.
There is an even more persuasive argument for Ohio expanding Medicaid and taking the federal funding. If the General Assembly doesn’t expand Medicaid, it will in effect send dollars from our state to the federal treasury for use in other states. We, the taxpayers of Ohio, would essentially bear the costs of the law but not receive any benefit.
To finance the health-reform law and the law’s Medicaid expansion, Congress made dramatic cuts to Medicare and Medicaid payments to providers, particularly hospitals. The biggest cuts are to specific Medicaid and Medicare hospital payments designed to help cover some of the costs of serving the uninsured.
In making these deep cuts to hospitals and other community safety-net support services, Congress assumed some of the lost care revenue would be made up through more patients being insured. These massive payment cuts go into effect regardless of what the General Assembly decides to do with Medicaid expansion. However, without expansion, Ohio hospitals and other service providers face a financial disaster that jeopardizes access to care for all Ohioans, the insured and uninsured.
Members of the General Assembly are honorable, well-meaning members of communities across Ohio. Like the rest of us, they encounter uninsured working adults every day. In his State of the State address, Gov. Kasich asked each Ohio lawmaker to “examine your conscience.” If our senators do this, they will vote to accept the federal funding, provide health insurance to the lowest income populations and mitigate the threat to health-care access for all Ohioans.
We look forward to working with our senators to develop a model that would extend health-care coverage to 275,000 hard-working Ohioans.
Carter and Turner are the co-chairs of the Akron-Canton Medicaid Expansion Coalition.