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Medicaid expansion plan in Ohio takes another hit

Apr. 24, 2013 @ 04:13 PM

TOLEDO, Ohio (AP) — Gov. John Kasich’s plan to expand Medicaid health insurance coverage to more low-income Ohioans as part of the state budget has come up against another roadblock from Republicans who control the Legislature.

The Senate’s version of the state budget won’t include the governor’s proposed Medicaid expansion, Senate President Keith Faber said Wednesday, but he said that Medicaid “reform” is not dead in Ohio.

Whether that includes Medicaid expansion — a key element of President Barack Obama’s signature health care law — is not as clear.

Lawmakers in the Ohio House and Senate will begin working on a Medicaid plan that is separate from the state budget, said Faber, who was careful to say that the focus will be on reform and long-term cost savings, not just the expansion of the taxpayer-funded health insurance program.

“That may include adding more people to the Medicaid system, but it has to include flexibility to perform and transform a system that works better for Ohioans,” Faber said.

Republicans in the Ohio House already had stripped the Medicaid proposal from the budget, but supporters were hopeful the Senate could revive it.

Kasich did not appear discouraged by the change in direction by the Legislature. “I don’t care how they do it. Just do it,” he said.

The governor has spent the past three months trying to persuade state lawmakers to go along with extending Medicaid coverage by drawing on a wide-range of people for support, from hospital executives to food bank operators.

He’s also appealed to the spiritual side of his fellow GOP legislators, telling them that the weak and vulnerable should not be left behind.

“I’m just going to keep at it because I think it’s the right thing for our state,” Kasich said Wednesday.

Roughly 366,000 Ohio residents would be up for coverage under the expansion beginning in 2014 if it’s approved.

The Medicaid expansion is one of the key components of the federal Affordable Care Act. Of the nearly 30 million people expected to gain insurance coverage under the law, about half would get it from the expansion. A Supreme Court ruling allowed states to decide for themselves whether to expand the program.

Kasich has said that going forward with the expansion will allow the state to recapture Ohio taxpayers’ federal money.

Many GOP lawmakers are averse to Obama’s law and resistant to expanding government programs. And some question whether the federal government will keep up with its share of the costs or pass along a bigger chunk of the bill to the states.

Faber, a Republican from Celina, said Wednesday that any Medicaid proposal must include cost savings and some flexibility on the part of the federal government.

The Kasich administration has been in talks with federal officials for months over whether President Barack Obama’s health law allows any flexibility to use the money from Washington to provide private coverage to some who would eligible under the Medicaid expansion.  

Lawmakers in Ohio still have many questions about the proposal and concerns about the federal government’s ability to pay the entire cost of the expansion for three years and 90 percent of the cost down in the following years.

Faber said that it’s possible a Medicaid plan could be finished this summer around the same time as the budget, but those talks also could go on into the fall.

Ohio has until the end of the year to decide on Medicaid expansion.
 

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