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.
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