Crowd urges for Medicaid expansion

COLUMBUS — Arguing that freezing Medicaid expansion enrollment would mean Ohio is turning its back on low-income adults who need health care, hundreds rallied Wednesday at the Statehouse less than 24 hours ahead of key House veto override votes.

“We came here for a fight today,” the Rev. Tim Ahrens, senior minister of First Congregational Church in Columbus, told the crowd, also suggesting that it’s un-American to not support low-income Ohioans who rely on Medicaid for health coverage.

“The people of Ohio are not being heard and not being accounted for,” he added. “We can’t leave behind 500,000 sisters and brothers across the state.”

The crowd urged Republican lawmakers not to vote Thursday to override Gov. John Kasich’s veto of a provision that his administration estimates would leave 500,000 Ohioans without health insurance within 18 months. More than 700,000 Ohioans currently get health care through the expansion, which has eligibility up to 138 percent of the federal poverty level.

Republican legislative leaders placed a provision into the budget to freeze Medicaid expansion enrollment starting in July 2018. Under the proposal, low-income adults who are not on Medicaid expansion at that date could not join. Meanwhile, those already on Medicaid expansion who get a higher-paying job and come off the rolls could not rejoin later if they lose the job, unless they are getting treatment for mental health or drug addiction.

The Ohio House is scheduled to meet Thursday morning to consider multiple veto overrides, including one on the Medicaid expansion freeze, and the Senate could follow July 12. Opponents of the expansion also are mobilizing, including the Ohio Christian Coalition and Americans for Prosperity, which is operating phone banks across the state to stir up their backers.

Dr. Keith Holten, a semi-retired physician in Grove City who attended the rally, said he has seen a tremendous increase in access to health care through the Medicaid expansion.

Holten said he has given care to many underserved patients over the years, including helping start free clinics. A lot of those clinics aren’t needed as much with Medicaid expansion, he said.

“It would really be going backwards in the state if we blocked and prohibited expansion,” he said. “A large number of the people who got Medicaid through the expansion are working one or two part-time jobs without benefits. This has allowed them to continue working.”

If the expansion goes away, Holten said, more people will get expensive primary care in emergency rooms.

“And they don’t get preventative care or cancer screening, and the list goes on,” he said.

While Kasich has spent much time in recent weeks with the national media urging federal lawmakers to cooperate on a bipartisan replacement of Obamacare that doesn’t leave millions of people without insurance, his unpopularity among Republicans inside his own Statehouse, and lingering opposition to the expansion, are driving a revolt against him.

Majority GOP lawmakers have never voted to override a Kasich veto, though some have been threatened in the past. But with Kasich is in his final term, plus a House that has grown increasingly more conservative and, some say, less enamored with the governor’s tactics, that could change this week.

Some Republican lawmakers have opposed the expansion for years, and they argue the growing cost of Medicaid is unsustainable. The federal government currently pays 95 percent of the expansion cost, but some worry that could drop much lower as Congress debates the Obamacare replacement, possibly costing the state far more than $1 billion per year.

After the budget passed, Rep. Tim Schaffer, R-Lancaster, stressed cutting the size of government.

“Particularly with our Medicaid plan, by freezing new enrollment and adding work requirements, we are shrinking this massive spending program to more sustainable levels.”

Talking to reporters on Wednesday, House Speaker Cliff Rosenberger, R-Clarksville, did not commit to an override vote, saying that Republicans members would discuss the possibility later in the evening.

“We’ll find out tomorrow what’s going to happen,” he said. “We don’t have to necessarily override vetoes tomorrow ... We have all the way to the close of business at the end of 2018 to override any of the governor’s vetoes, if we feel like we need to.”

In addition to the Medicaid expansion freeze, GOP legislative leaders are expected to seek a number of other overrides, particularly of Medicaid provisions, such as one granting lawmakers authority over increasing Medicaid rates.

Rosenberger said last week that he would not take up the veto override on the floor unless he had the votes to accomplish the task.

“Sixty-six (GOP) members, that’s a lot of people to corral,” he said. “We’re going to have the discussion. There’s some issues members are extremely passionate about.”

The House needs a three-fifths vote — 60 of 99 members — to override Kasich’s vetoes.

A freeze on enrollment and other limits on Medicaid spending remain top areas of disagreement. The speaker also mentioned lawmakers’ approach to helping counties and transit authorities deal with a Medicaid-related sales tax issue that will cost them about $200 million per year. Kasich vetoed a proposed six-year funding fix.

“The (funding) issue is, of course, very important to a lot of local communities,” Rosenberger said. “It’s very important to a lot of our members. We’ll look at it.”

If Republicans override the veto, the Kasich administration would have to seek a federal waiver to get approval for the enrollment freeze. The budget bill does not include a specific date upon which the waiver must be filed, so there has been speculation that Kasich could sit on it.

In his veto message, Kasich said the Medicaid expansion population has seen improved access to care, less use of costly emergency rooms.

“This provision is in violation of federal law, which prohibits states from denying coverage to members of an otherwise eligible group,” Kasich wrote. “This provision would eliminate any chance of these improvements continuing on a going forward basis to the detriment of the state’s economy in general and needy Ohioans in particular.”

Dr. James Misak, an assistant professor of family medicine at Case Western Reserve University, told the crowd of how Medicaid expansion helped a patient with diabetes and another with lung cancer, both of whom were treated and are back at work.

“This is exactly what health insurance is supposed to do,” he said, while also praising the operation of Ohio’s Medicaid program. “It’s a national leader in encouraging doctors like me and hospitals like many of us work at to deliver cost-effective and efficient care.”

If conservatives needed another reason to show up for Thursday’s House session, the chamber also plans to vote on legislation that would largely eliminate the legal consequences for carrying a concealed handgun into places where it is currently prohibited, such as day-care centers, school safety zones, airports and police stations.

Under House Bill 223, those with a concealed-carry license would not face legal penalties if the person leaves the premises on request. The Fraternal Order of Police of Ohio has opposed the bill, arguing it sets up situations requiring people to confront people carrying concealed weapons and could have people carrying guns in police stations.

GateHouse Media Ohio reporter Marc Kovac contributed to this story.

CREDIT: JIM SIEGELGATEHOUSE OHIO MEDIA