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Obamacare roadshow: Watchdog covers the cost of Gov. Kasich’s Medicaid expansion

By Andrew Collins 6a00d8341bf7d953ef01b7c731d077970b

Ohio Gov. John Kasich’s poll numbers may not be skyrocketing, but the cost of expanding Medicaid in his state certainly is.

For Watchdog readers, neither of these things will come as a surprise. When Kasich announced his bid for the presidency last year, Watchdog’s coverage of his major policy decisions as governor of Ohio had already been nearly a year in the making. Since then, Kasich’s presidential campaign has brought

his controversial decision to take advantage of President Obama’s unpopular 2010 healthcare law into the spotlight as Republican primary voters decide whether the Ohio governor’s policies align with their values.

Kasich’s Obamacare expansion

Watchdog reporter Jason Hart first took up the story in September 2014. Ohio’s Medicaid enrollment under the expansion had just topped 367,000, passing Kasich’s initial projection for enrollment levels at July 2015. In the year and a half since, the governor’s projections for his state have continued to fall far short of the actual tally. Last March was themost expensive month yet for the expanded program, costing taxpayers $411 million as more working-age adults with no kids and no disabilities flocked to the Medicaid rolls. This puts Kasich’s Obamacare expansion on track to cost $28.5 billion by the year 2020 – more than twice as much as his administration projected.

This has raised questions from critics who worry that expanding health care for able-bodied adults could be a disincentive to work. How many of the Ohioans who have recently enrolled in Medicaid have jobs?

No one knows, not even the Ohio Department of Medicaid. Last Spring, the department told state Senate members that 43 percent of enrollees were employed, but it has no current data on how many of Ohio’s 673,000 Obamacare expansion enrollees are gainfully employed. ODM also doesn’t track how many of these new enrollees had private or employer-sponsored health insurance prior to enrolling in Medicaid – or how many of them are incarcerated.

Never mind that Kasich initially estimated 447,000 people would sign up under the expansion by 2020. That means that “if ODM capped Obamacare expansion enrollment at its current level,” wrote Hart, “the two-year-old program would already be 48 percent larger than the Kasich administration said it would be after seven years.”

Lest anyone be confused about how Medicaid expansion became part of Ohio law in the first place, Hart has a helpful breakdown of how the policy fight played out in 2013:

  1. The Ohio House stripped the Obamacare Medicaid expansion from its version of the 2014-15 budget.
  2. The Ohio General Assembly explicitly banned expansion in the final 2014-15 budget sent to Kasich’s desk.
  3. Kasich used a line-item veto to strike the legislature’s ban on expansion.
  4. The Kasich administration, with approval from the Obama administration, expanded Medicaid to the guidelines set in Obamacare.
  5. The Kasich administration asked the Ohio Controlling Board to appropriate funding to pay for the Medicaid expansion.
  6. The Ohio Controlling Board approved Kasich’s Obamacare expansion funding request.
  7. Six Republican legislators and two Right to Life groups sued over Kasich’s Controlling Board maneuver, but the Ohio Supreme Court ruled in the Kasich administration’s favor.

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