EDITORIAL: Beneath Rob Portman

Akron Beacon Journal (OH)

June 17--U.S. Sen. Rob Portman won re-election last fall with a campaign that put at the front the opiate epidemic. It was the smart political play and intelligent policymaking. The Cincinnati Republican backed his words with action in Congress. He listened, eager to know more about the heavy toll of drug addiction in Ohio.

The senator has sustained that posture as his party has moved to repeal and replace the Affordable Care Act. He recently told the Columbus Dispatch that "my goal is to ensure that those on expanded Medicaid continue to have good health care options under a new system." He notes how 30 percent of those covered by the Medicaid expansion here receive treatment for mental illness and/or drug addiction, and that they represent one-half of the cost.

Now consider the disappointing direction taken by Portman and his Senate colleagues as they put together their version of a replacement. They may produce something better than the cruel American Health Care Act narrowly approved in House. They won't get close to the goal Portman set.

The House version abruptly ends the enhanced federal contribution for the Medicaid expansion. Portman has pressed for a longer period to phase in the reduction, as much as seven years.

And then, what would be the available "good health care options"?

The Medicaid expansion would end -- at the expense of those needing treatment for mental health care and drug addiction, among others who are poor and vulnerable. Might private insurers fill the coverage gap? Nothing in the Republican plans suggests such an outcome.

Gov. John Kasich recently reiterated his willingness to phaseout the enhanced federal payments and the expansion. He added that states would need sufficient resources and flexibility. What are the odds of Ohio putting up or receiving a projected $1.3 billion a year, as recently calculated by the Center on Budget and Policy Priorities?

Recall that Republicans want to apply per-capita limits on Medicaid spending, as they slash $830 billion from the program during the next decade. That ensures fiscal pressure on states as they face the range of Medicaid priorities, including one of every two children in Ohio, students with special needs and hospitals likely coping again with an increasing cost of uncompensated care.

Add the factor of Medicaid as a support for many families across a broad range of income levels as they watch parents age and enter assisted living or nursing homes.

So, yes, a Senate bill may be better than the House version. Still, many would lose their health insurance or face less coverage. No surprise that physicians, nurses, hospitals and patient advocacy groups oppose the House bill and warn about the same, essentially, emerging from the Senate.

All of this disruption would result from a legislative process that should embarrass Portman. For all the back and forth among Republicans, the episode has been rushed, opaque and without the months of hearings, discussions and time devoted to the Affordable Care Act. And Republicans complained about that process.

They seemingly are ready to take a final bill straight to the Senate floor for a vote. This is what the invariably informed and careful Sen. Portman is prepared to support? And to what end?

Republicans propose taking from the needy to clear the way for tax cuts directed almost entirely to the wealthy. Rob Portman campaigned for something much better, and with Republicans having just 52 votes, he has the clout to push for a more effective approach and outcome. As it is, this process is beneath him.

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