Governor John Kasich, who warned in 2010 that Obamacare would “require more Medicaid spending and stick states with large and unsustainable costs,” has been trying to stick Ohio with those costs for six months. If he has compelling reasons for doing so, he has not shared them.
A 2012 U.S. Supreme Court decision gave states the freedom to opt out of expanding Medicaid to able-bodied childless adults, but Kasich has sided with hospital lobbyists and progressive activists in pursuit of a policy he campaigned against.
How did John Kasich, a Republican known for his fiscal conservatism, decide to support a key piece of Obamacare?
“It’s a complicated issue,” Gov. Kasich told reporters when Ohio Treasurer Josh Mandel came out against the Obamacare Medicaid expansion in February.
It’s not as complicated as Kasich would have Ohioans believe. Fortunately for the governor, he has faced no difficult questions from a Statehouse press corps happy to herald billions per year in new entitlement spending.
A January 15 Health Policy Institute of Ohio (HPIO) study estimated Ohio’s economy would benefit from a vast expansion of Medicaid. Ever since, HPIO’s findings have been trumpeted by the Kasich Administration and the press – though free market think tanks Opportunity Ohio and The Buckeye Institute had both pointed out major flaws in the study by the end of January.
With extensive use of his bully pulpit, Gov. Kasich has built arguments for the Obamacare Medicaid expansion around a few simple themes, and has framed as a heartless ideologue anyone who disagrees. He has even bizarrely claimed Obamacare is not Obamacare.
Kasich Talking Point: Obamacare Medicaid expansion will make poor Ohioans healthier
Governor Kasich and other Obamacare advocates insist expanding Medicaid will help Ohio’s poor by providing them access to better health care. This claim is typically made as a blanket assertion that “Medicaid coverage” means “quality health care,” with no supporting evidence save assurances from Kasich that God wants the General Assembly to spend more taxpayer money.
- Foundation for Government Accountability (FGA) studies of Medicaid expansions in Arizona, Delaware, Maine, and Oregon showed that in each state, the percentage of the population without health insurance remained the same while many citizens shifted from private health insurance into Medicaid
- As of 2011, 28 percent of Ohio’s office-based physicians were already refusing to treat new Medicaid patients
- A 2010 University of Virginia review of nearly 900,000 surgical procedures found that Medicaid patients were 13 percent more likely to die than patients with no health insurance
- A study released May 1 in The New England Journal of Medicine concluded that Oregon Medicaid coverage “generated no significant improvements in measured physical health outcomes in the first 2 years”
The Obamacare Medicaid expansion would push hundreds of thousands of able-bodied childless adults under the age of 65 into a government program whose results are already mixed at best.
Kasich Talking Point: Obamacare Medicaid expansion will help Ohio hospitals and boost Ohio’s economy
The Kasich Administration and hospital lobbyists paint a picture of two future Ohios. In one Ohio, the state adopts the Obamacare Medicaid expansion and billions of job-creating federal dollars rain down from the sky; in the other, the state’s failure to expand Medicaid stifles the economy and sends hospitals around the state into bankruptcy.
How do these portrayals compare to reality?
- A working paper published by the National Bureau of Economic Research in July found that cutting able-bodied childless adults from Medicaid in Tennessee “resulted in an approximately 6 percent increase in employment over the following two years,” as Tennesseans sought jobs to make up for lost entitlement benefits
- This spring, the Obama Administration proposed delaying Obamacare’s cuts to Disproportionate Share Hospital (DSH) payments that hospitals currently receive to offset the cost of providing care to the uninsured
- Even with no DSH payments or other charity care offsets, most Ohio Hospital Association members would have recorded millions in net income during their latest fiscal years
- The Ohio Hospital Association executives pleading for more taxpayer money are payed hundreds of thousands – if not millions – of dollars per year
Kasich Talking Point: “Ohio’s” Obamacare funding will be spent elsewhere if Ohio rejects Medicaid expansion
From the day he introduced his budget plan for fiscal years 2014-2015, Gov. Kasich has been arguing that implementing the Obamacare Medicaid expansion would prevent “leaving Ohioans’ federal tax dollars on the table,” (02/04/2013 budget summary) and stop DC from taking “$13 billion of Ohioans’ federal tax dollars out of our state” (02/06/2013 RedState post).
This is an utterly false line of argument that Ohio news reporters have nonetheless repeated time and again without question.
- Not only would Ohio’s rejection of the Obamacare Medicaid expansion prevent billions per year in new spending from a national government already $16.7 trillion in debt, it would prevent new state Medicaid spending exceeding $500 million per year by 2021
- Cato Institute Health Policy Director Michael Cannon, one of America’s leading health policy experts, refuted the governor’s funding rhetoric in March testimony before the Ohio House
- HPIO’s January study framed Obamacare spending as free money, but not even HPIO is willing to support Kasich’s claims that other states will get “Ohio’s” funding if Ohio rejects the Obamacare Medicaid expansion
- Louisiana Governor Bobby Jindal, the current chair of the Republican Governors Association, debunked Kasich’s Obamacare Medicaid expansion funding arguments in a July 23 editorial