It was one of the worst kept secrets at the Statehouse - that since the Republican dominated legislature was stalling on and leaning against Medicaid expansion, Gov. Kasich was considering doing an end run around lawmakers to get it done. The governor had been asked whether he’d do this by executive order, but last month said he felt he needed what he called a "sign-off" from the legislature.
“You need to have some agreement with them in one way or another as to how you proceed because you don’t want to get yourself into some sort of showdown where you run out of money and you force them – that’s not the way to do things.”
And the Controlling Board was seen as the most likely path toward Medicaid expansion if the legislature didn’t act on it. And indeed, Kasich is asking the Controlling Board to approve spending federal funds for Medicaid expansion, after having received the okay from the feds on Thursday to extend Medicaid coverage to adults making up to 138 percent of the federal poverty level.
Greg Moody is the director of Kasich’s Office of Health Transformation, and says because only federal money is involved, this is a good decision.
“I do think it would be accurate that if state funds were involved, it would require more legislative engagement. However, the Controlling Board is intentionally designed to allow the state to receive federal-only appropriations. So it’s well within the authority of the administration to make the request, and it’s well within the authority of the Controlling Board to approve the request.”
Moody says the administration felt it was time to do this now, because the federal government will pay all the costs of Medicaid expansion for three years starting January 1. And he says the state launched a new online eligibility system for Medicaid on October 1 without any major glitches, and that’s the system that will be used for Medicaid expansion.
Conservatives in the legislature have been opposed to the idea since Kasich proposed it in his budget. Predictably, Tea Party leaders are outraged. Chris Littleton with the Ohio Liberty Council says it goes against the so-called Health Care Freedom Amendment they worked to pass in 2011.
“This is a defiance of what people are wanting in Ohio when it comes to more government control of health care in their lives. I don’t think they want that.”
Just announcing the intention to go to the Controlling Board doesn’t make Medicaid expansion a done deal. There are six lawmakers on the Controlling Board – two Republican state senators, two Republican state representatives and a Democrat from each chamber, and Kasich’s appointee Randy Cole as the board’s president and the seventh vote. So the governor would need one of the four Republicans to vote with him for Medicaid expansion to pass.
The spokesperson for the House says no changes to the Controlling Board have been made, and the Senate’s spokesperson says there are no plans to make any changes.
The Controlling Board will take up the Medicaid expansion request on October 21.