Commentary: Don’t Freeze The Medicaid Expansion

John Kasich vetoed three controversial bills last week as the end of his eight-year tenure as governor of Ohio approached.

Now the Republican majorities plan an attempt to override his action, with Thursday set aside for a rare holiday gathering of the legislature. They will attempt to preserve a most extreme and unconstitutional six-week ban on abortion, plus pay increases for themselves and other public officials and a widening of gun rights, prosecutors given the new task of proving a defendant did not act in self-defense.

The governor acted reasonably in each instance. If anything, he abandoned the logic of his own thinking by signing into law another extreme and unconstitutional restriction on abortion rights, legislation outlawing the most common procedure for second-trimester abortions without exceptions for rape or incest.

And yet, one more potential veto override looms, and it may pose the greatest harm in scope.

Recall that in signing the current state budget, the governor used his line-item veto to remove language that would freeze the Medicaid expansion. He vetoed other provisions, and the Republican majorities found the votes to mount successful overrides. That hasn't been the case with the expansion freeze.

Will they try as the legislative session comes to an end?

It is worth stressing what a big mistake the freeze would be. It would deny access to health care coverage that has been a boon to Ohio. The legislature called for regular and independent assessments. Two have been conducted since the start of the expansion in 2014. Each has revealed the clear benefit.

The expansion has brought coverage to roughly 700,000 Ohioans with incomes just above the poverty level. With coverage, they are more likely to see primary care physicians on a regular basis. Thus, costly visits to emergency rooms have declined. In large part, that is because chronic conditions, from diabetes to depression, have been identified and managed effectively, leading to an improved quality of life, including decreased medical debt.

Many served by the Medicaid expansion already work. They report that steady coverage helps them both stay employed and search for a job, perhaps with an employer offering health insurance. Policy Matters Ohio recently performed an analysis of what the state economy would look like in 2019 -- with or without the expansion. It found the expansion would result in an additional 54,000 part-time and full-time jobs. That hardly surprises given the influx of federal dollars bolstering incomes and rippling through a health care industry key to the state economy.

More, the benefits flow to larger and smaller communities. The expansion has been a lifeline, especially for hospitals in rural areas.

Ohio still faces an opioid epidemic, and the expansion has been crucial to the state response. As Loren Anthes of the Center for Community Solutions notes, nearly 100,000 expansion enrollees face a substance abuse disorder, and of the $940 million a year the state spends on addiction, Medicaid accounts for $650 million -- with $300 million stemming from the expansion.

This role in the opioid epidemic amounts to argument enough for resisting a freeze. The state doesn't need a deeper addiction crisis. It is well served by the Medicaid expansion, something it can afford in view of a decade or more of tax cuts tilted heavily to wealthier households. The expansion reflects how government can play an essential role in enhancing opportunity, putting Ohioans in a better place to succeed.

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