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Medicaid expansion demands the support of state legislators



Published: Thu, September 26, 2013 @ 12:00 a.m.

As the Ohio General Assembly prepares to convene its fall lawmaking session in Columbus, some rightly worry whether the state House of Representatives has degenerated into a clone of its namesake at the U.S. Capitol.

As the U.S. House has become dominated by ultra-conservative voices of the political right, so, too, has the Ohio House. As the U.S. House has focused inordinate time and energy on pushing its right-wing — often extremist — agenda, so, too, has the Ohio House. As the U.S. House has used its clout to block sensible legislation, such as the Affordable Care Act, so, too, has the Ohio House in blocking forward-thinking expansion of Medicaid insurance to 275,000 men, women and children.

Before state legislators return to the Statehouse next week to begin what should be a busy season of lawmaking, we’d urge all of them to swallow a healthy dose of political pragmatism, the reasonable and logical way of thinking about issues divorced of preconceived and hardened ideologies.

As the Columbus Dispatch pointed out in a recent examination of the state Legislature, the Ohio House has taken a sharp turn to the political right, as evidenced most vividly in its machinations on the state’s 2014-15 budget that dominated the first six months of this year.

Ohio Gov. John Kasich’s proposed two-year state budget in February contained no major anti-abortion provisions, a severance tax on shale drilling and a largely federally funded Medicaid expansion. The budget that was returned for his signature in late June contained five anti-abortion provisions that received little or no public airing, no fracking tax and a provision specifically forbidding Medicaid expansion, which Kasich wisely vetoed.

Such examples of crafty backroom legislating and overly ideologically based governing must be reined in as the General Assembly faces a mountain of important public-policy issues during the final three months of the year. Among them are proposals on voting procedures, school-curriculum reform, tax policies, energy- efficiency standards, oil and gas drilling regulations and a host of other hot-button issues.

THE CASE FOR MEDICAID EXPANSION

Arguably, the most pressing issue facing state representatives and senators this fall should be expansion of Medicaid eligibility, tied to the federal government’s Affordable Care Act. Ohio remains among a small handful of states that have failed to decide definitively on whether the state’s working poor deserve inclusion in the state and federal health-insurance program.

Swift action is critical because federal officials say legislative sign-off on the expansion is necessary by early fall to allow newly eligible enrollees to be covered by January when the program kicks in.

House Republicans’ ongoing opposition defies logic on several fronts. Their inaction paints them as more interested in rejecting a key provision of their despised president’s health-care law than in providing an opportunity for working Ohio families to get medical coverage and for Ohio medical providers to get paid for the services they already provide for free.

As The Vindicator reported this week in its series on the ACA, Obamacare will begin reducing payments to hospitals for uncompensated care for the poor next year. But hospitals in states that expand Medicaid will require substantially less money because more of the poor will have Medicaid coverage. Ohio State University projects that the new federal Medicaid money coming into Ohio would total about $7.3 million a day.

Clearly the expansion makes sense on grounds of fiscal responsibility, business savvy and human compassion. That’s why recalcitrant Ohio House Republicans and all state legislators should act expeditiously to add Ohio to the list of states that have adopted this progressive and humanitarian reform.


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