Fellow conservatives in the House slammed Gov. John Kasich's plan to expand the tax-funded Medicaid program, saying yesterday that it is a bad deal for taxpayers and the uninsured. GOP lawmakers said providing health coverage to an additional 275,000 poor and disabled Ohioans will make it more difficult for them to escape poverty while increasing the national debt.
Fellow conservatives in the House slammed Gov. John Kasich's plan to expand the tax-funded Medicaid program, saying yesterday that it is a bad deal for taxpayers and the uninsured.
GOP lawmakers said providing health coverage to an additional 275,000 poor and disabled Ohioans will make it more difficult for them to escape poverty while increasing the national debt.
During more than six hours of testimony before a House committee, Republicans made it clear that their opposition to President Barack Obama's health-care law trumps the Kasich administration's stance that the expansion will save Ohio taxpayers $404 million over the next two years.
"Clearly, this is an unsustainable position for the federal government, and there will be a day of reckoning," said Rep. Robert Sprague, R-Findlay. "We will either have higher tax rates as American citizens or our borrowing power will be reduced as a nation."
Greg Moody, director of the Governor's Office of Health Transformation, told the House Finance Committee that Kasich supports a balanced federal budget but that expanding Medicaid is a good deal for Ohio.
"Would I rather take the money and not spend it and drive down the deficit? Absolutely, but that's not a choice," Moody told lawmakers.
Under Obama's health-care law, the federal government for three years would pay all costs to expand Medicaid to those with incomes up to 138 percent of the poverty level - about $23,000 a year for a family of four. The federal match decreases over the next several years to 90 percent of the cost.
The expansion would provide coverage to more low-income uninsured, allowing them to meet the requirement beginning in 2014 that most Americans have health insurance or face a penalty. In addition, it would free up local money for mental-health and addiction services, shift some state costs for prison health care to Medicaid and generate other savings.
Kasich's proposal also includes a provision that would repeal the expansion if the federal government lowers the matching rate.
Moody said Kasich, like many of his fellow Republicans, opposes much of Obama's Affordable Care Act, but he's pushing to expand Medicaid because "it's making the most of a hand we've been dealt."
Ohio businesses, hospitals, advocates for the uninsured and others have joined Democrats to support the expansion.
"If we don't do this, we are subsidizing other states," said Rep. Mike Foley, D-Cleveland.
Moody concurred, noting that Ohioans pay taxes to the federal government that will finance Medicaid expansions in states that decide to increase program eligibility.
"If we don't spend it, it's not like that money will be saved. We are still paying it in our federal taxes," he said. "The question is: Is the money coming back to Ohio, or is it going somewhere else?"
Finance Chairman Ron Amstutz, R-Wooster, said that "the argument could be made that there are no state tax dollars involved here unless you look down to our grandchildren and what they will pay."
Rep. Gerald Stebelton, R-Lancaster, suggested that Ohio hold out to "negotiate a better deal" with the federal government.
"The best leverage we have with the federal government is to opt out."
State officials noted that Medicaid rolls will grow with or without an expansion as an estimated 231,000 uninsured Ohioans currently eligible for coverage are expected to sign up because of the new health-insurance mandate. The state cost for the so-called woodwork effect is projected to be $521 million over the biennium.
Moody said yesterday the costs would be covered in large part by cutting payments to hospitals and managed-care companies, health-care providers who stand to benefit most from increased enrollment.