EDITORIAL: Overdrive on the overrides in the Ohio House

July 09--John Kasich brought Democrats and Republicans together at the Statehouse last week. The governor experienced something else unusual. For the first time in four decades, according to the Legislative Service Commission, the Ohio House voted to override a line-item veto involving the state budget -- and not once but 11 times. On a handful of the votes, the bipartisan majorities were overwhelming.

Fortunately, this rare show of defiance did not include the governor's veto of a provision freezing enrollment in the Medicaid expansion next year. Republicans in charge of the House put off a vote. They cited the uncertainty in Washington, where Republicans are trying to reshape the Affordable Care Act. That means, for now, the state continues to benefit from more than 725,000 Ohioans gaining health coverage.

Mostly, lawmakers looked to achieve a larger hand in managing Medicaid, the joint state and federal health care program for the poor and vulnerable, including one-half of the state's children. That was especially so for Republicans, and it is curious position, given that the governor's team has proved adept and innovative, curbing costs while pressing for improved quality.

This has been a clear area of achievement. Now Republican lawmakers would do better?

Consider, for instance, the override that would delay moving Medicaid long-term services to managed care. Nearly two dozen other states have taken this path and made gains, in savings and health outcomes. Ohio has made progress of late, after addressing early problems.

Republicans and Democrats followed the lead of the powerful nursing home lobby. They also did so in overriding the veto of a provision that eases quality and accountability measures for nursing homes, not to mention limits the authority of the administration to set payment rates.

With their overrides, Republicans would restrict the responsiveness of the State Controlling Board, add a layer of bureaucracy for the Joint Medicaid Oversight Committee and make more difficult coverage for optional groups.

They would waste state time by requiring the governor to seek federal approval of Healthy Ohio, a proposal that calls for Medicaid recipients to pay premiums, among other requirements. Federal officials already rejected the plan because it violates a law -- yes, still on the books.

The governor's team reinforced its case by showing how lawmakers have left Medicaid $1.4 billion short of the funds required to run the program. Evidently, Republican lawmakers assumed savings yet prevented the state from making the necessary spending reductions, and even added spending for nursing homes.

No question, as George F. Will of the Washington Post argues on today's Commentary page, Medicaid spending crowds other crucial priorities at the state and federal levels. At the same time, it operates more efficiently than private insurers. It is part of a larger health care system afflicted by excessive costs. An unrealistic limit on spending just promises to hurt the needy.

To its credit, the governor's office has been seeking to slow the upward cost curve. If it has stumbled at times, it has succeeded in the main and deserves the confidence of lawmakers. Instead, the House would make managing Medicaid harder. The hope is, the Ohio Senate will be more judicious about what it seeks to override.

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