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Ohio budget relies on billions in new Obamacare spending

By   /   February 5, 2015  /   News  /   No Comments

Part 6 of 27 in the series Ohio's Obamacare expansion

By Jason Hart | Ohio Watchdog

Ohio Gov. John Kasich’s budget plan released Monday reasserts his commitment to Obamacare’s Medicaid expansion and the resulting new federal spending.

With enrollment climbing every month, Kasich’s Obamacare expansion cost federal taxpayers more than $2.1 billion in its first year. The expansion has cost so much more than Kasich projected that an appropriation to pay for it through June 30 will likely run out this month.

Even if Obamacare’s federal Medicaid expansion funding is not cut, state taxpayers will be on the hook for 10 percent of benefit costs by 2020 — not an inconsequential sum with claims already exceeding $300 million per month.

Unless overturned by the Ohio General Assembly, Kasich’s Obamacare expansion will likely cost more than $7 billion during the next two fiscal years.

Medicaid is the largest program in the Republican governor’s “Blueprint for a New Ohio” executive budget for fiscal years 2016 and 2017. Kasich is calling for $55.6 billion in Medicaid spending from July 1, 2015, through June 30, 2017.


Assuming 100 percent of Medicaid expansion benefits are paid for by the federal government through 2016 as Obamacare promises, any cost-cutting measures in Ohio’s Medicaid program through Dec. 31, 2016 will have to target traditional Medicaid recipients.

Several proposals included in Kasich’s budget do just that, undermining the governor’s claims he embraced the Obamacare expansion out of concern for Ohio’s most vulnerable.

Ohio women with income up to 200 percent of the federal poverty line are currently eligible for Medicaid if they are pregnant or need breast or cervical cancer treatments. Kasich’s budget calls for cutting off this coverage at 138 percent of the poverty line, the ceiling for the Obamacare expansion.

“Currently, individuals in these groups are eligible for Medicaid up to 200 percent of poverty, but those levels were set when the federal exchange did not exist and the only alternative to Medicaid was to be uninsured,” a budget document from the governor’s office explains.

This recommendation comes despite Kasich’s insistence his Obamacare expansion, which covers no children and no pregnant women, has reduced infant mortality.

“Gov. Kasich’s proposed budget makes welfare for able-bodied adults a higher priority than care for the truly needy,” Jonathan Ingram, research director at the free-market Foundation for Government Accountability, said in an email to Ohio Watchdog.

“Kasich’s already pushed tens of thousands of children and adults with developmental disabilities on Medicaid waiting lists to the back of the line to make room for his ObamaCare expansion. He’s already targeted pediatric hospitals for funding cuts,” Ingram continued.

“Now he’s proposing to eliminate coverage for some groups of pregnant women and women receiving treatment for breast or cervical cancer,” Ingram said. “When the ObamaCare bill comes due, who else will he put on the chopping block?”

Kasich’s budget plan also reduces spending by cutting Medicaid managed care payments to the lowest rate permitted by the federal government. Nearly 80 percent of Ohio Medicaid beneficiaries are covered by a managed care plan.

Access to care is a problem for Medicaid recipients because the program’s reimbursement rates are so low. A 2014 survey found 40 percent of doctors in the Ohio State Medical Association planned to see fewer Medicaid patients when a temporary reimbursement increase expired at the end of the year.

The governor’s budget includes slight increases to primary care, pediatric physician and dentist payment rates, but pays for these increases by reimbursing doctors at lower Medicaid rates for patients enrolled in both Medicaid and Medicare.

Kasich unilaterally expanded Medicaid in 2013 after line-item vetoing the Ohio General Assembly’s prohibition of the Obamacare expansion. Kasich then pressed the quasi-legislative Ohio Controlling Board to appropriate $2.56 billion in Obamacare money, warning the Ohio Medicaid program would go bankrupt without it.

Based on 2014 expenditures, the first 18 months of Obamacare expansion benefits will cost at least $1 billion more than Kasich anticipated.

Part of 27 in the series Ohio's Obamacare expansion
  1. Obamacare expansion passes Ohio governor’s July 2015 projection
  2. Will Ohioans be taken in by Obamacare Medicaid spin?
  3. Ohio Gov. Kasich wants rubber stamp for Obamacare money
  4. Obamacare adds 450,000 Ohioans to Medicaid rolls
  5. Ohio: Who’s paying for Kasich’s Medicaid expansion?
  6. Ohio budget relies on billions in new Obamacare spending
  7. Ohio Obamacare expansion 33 percent over budget in first year
  8. Two-thirds of Ohio’s Obamacare enrollees are on Medicaid
  9. No money, no problem for Ohio Obamacare expansion
  10. Obamacare puts half a million Ohioans on Medicaid
  11. Ohio lawmakers show no inclination to stop budget-busting Obamacare expansion
  12. Ohio House Republicans embrace Obamacare expansion
  13. Ohio Obamacare expansion costs $3 billion in first 15 months
  14. Ohio’s Obamacare expansion already $1 billion over budget
  15. At $4 billion, Ohio Obamacare expansion blows past projected costs
  16. Ohio’s dependence on Medicaid is the worst in the Midwest
  17. Three-fourths of Ohio Obamacare enrollees are on Medicaid
  18. Ohio Medicaid spending is skyrocketing under Gov. Kasich
  19. Ohio’s Obamacare expansion has cost taxpayers $5 billion
  20. Ohio Obamacare expansion keeps getting bigger
  21. Has Ohio Gov. Kasich really restrained Medicaid growth?
  22. Flashback: Gov. Kasich’s Medicaid expansion end-run
  23. Kasich’s Medicaid expansion has cost taxpayers $7 billion
  24. Ohio Medicaid expansion sign-ups keep crushing projections
  25. How many Ohio Medicaid expansion enrollees have jobs?
  26. Ohio Medicaid expansion costs top $7.5 billion
  27. Ohio’s budget-busting Medicaid expansion trend continues


Jason was formerly a reporter for Watchdog.org