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Health and Medicine

Ohio's GOP Gov. Kasich seeks state health-care options for poorer people
Gov Kasich could get Medicaid expansion without approval from state lawmakers

Jo Ingles
Ohio Rep. Barbara Sears is one of the few Republican lawmakers publicly pushing for expansion of Medicaid. So other options are being explored.
Courtesy of State of Ohio
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Beginning Tuesday, Ohioans can sign up on the new marketplace for health insurance called exchanges.

But thousands of low-income Ohioans would be eligible for Medicaid coverage if the state were to expand the program, with the federal government picking up nearly all the cost.

They're still waiting to learn their options because GOP lawmakers have balked at expanding Medicaid, despite the fact that Gov. Kasich wants that to happen.

As Ohio Public Radio’s Jo Ingles reports, there are still some options that could be pursued if the governor decides to do it.

Hear more on the push for options

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It’s not every day that Republican Gov. John Kasich and Democrats agree on issues. But when it comes to the issue of expanding Medicaid to cover 275,000 low-income Ohioans, they agree.

They do not agree, however, on how that should be done. 

The Republican-dominated legislature has not passed Medicaid expansion outright. Lawmakers want to reform the program instead, but there is no plan in place right now to do that either. 

Democrats, like House Rep. Denise Driehaus have been urging Gov. Kasich to use what’s known as a discharge petition to force lawmakers to vote on the issue now. 

She says constituents in her district are frustrated.

“People simply don’t understand and to be honest with you, I don’t have a very good explanation as to why we are not getting this done and I told them I share their frustration,” Driehaus said.

Back in July, Gov. Kasich said he still wants Medicaid expansion but was clear doesn't want to use heavy-handed tactics to get it.

“If I put people in a corner, I am unlikely to get what I want to help people who need help,” Kasich said.  “Now if I just be persistent and pleasant and working on this now, all options are on the table.”

And one of those options is...
Republican House Rep. Barbara Sears explains one option. She, like Gov. Kasich, wants Medicaid expansion.  And she says one way to get it would be for Kasich to sign an executive order to expand Medicaid, then take it to a legislative panel for approval.

“The Llegislature has given him that tool in previous budgets,” Sears said. “So we gave him the opportunity to do this by executive order so he does have the opportunity to do that. He does need to come back to the Controlling Board to fund but he wouldn’t even need to do that right away.”

But so far, Kasich has given no public indication that he will issue an executive order to expand Medicaid. 

Neil Clark, who oversaw work on budgets for the Senate Republican Caucus in the 80’s, says it wouldn’t be unprecedented for a governor to use an executive order for something like this.

“Those have been done numerous times through every governor’s administration,” Clark said. “Those executive orders, of course, terminate at the end of his term so in the short term, an executive order would be a temporary solution to start Medicaid expansion in Ohio.”

And yet another path
In fact, Clark says there’s a way that Ohio could get the money for Medicaid expansion even if the governor doesn’t issue an executive order.

Clark says the administration could ask the Controlling Board for the federal money offered through Medicaid expansion.

"The Controlling Board can take the 90 percent (federal match) if it were in the form of a grant ... if there were suitable funds available to make that 10-ercent match that didn’t increase the GRF appropriation or expenditure."

Clark says that means if the agency could come up with the 10 percent from its own funds, the federal money could be put into the Medicaid program. 

At any rate, any action like this would require a seven-day notice to the Controlling Board, which hasn’t been given yet. 

Meanwhile, legislative leaders who’ve been working on Medicaid expansion, including Rep. Sears, say they will come out with a bill soon.

But on Tuesday, when many Ohioans are starting to explore their options, low-income Ohioans who would qualify for Medicaid expansion still won’t know theirs.

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