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Controlling Board or Not, Medicaid Expansion Seems Destined to Happen

Medicaid Expansion has been the hot topic of conversation for almost a year.  As to the policy, the pros and cons have been weighed more times than any one of us care to recount.  Strategically, the recent move by Governor John Kasich to ask the Controlling Board to take action on Expansion certainly isn’t the most popular move.  And a group of House Republicans seem to think it may not be constitutional:

House Republicans are preparing to potentially sue GOP Gov. John Kasich over taking Medicaid expansion to the state Controlling Board, and they would base their lawsuit on the arguments laid out in a formal protest they filed yesterday.

Thirty-nine GOP representatives signed a letter in protest of Kasich’s plan to ask the seven-member legislative-spending oversight panel on Monday to approve $2.56 billion in federal money over two years to cover about 275,000 more poor Ohioans under Medicaid. They said Kasich’s maneuver will circumvent the “clear intent of the General Assembly,” a violation of Ohio law.

While I can certainly sympathize with House Republicans—and believe wholeheartedly that Medicaid Expansion deserves a full vetting before both chambers of the General Assembly—I can’t believe that a legal challenge can stand.  As the Dispatch article goes on to explain, the law seems to be on the side of the Controlling Board.

The lawyers at Vorys, Sater, Seymour and Pease offered a legal opinion saying that the Controlling Board has the authority to act to expand Medicaid.  Say what you want about whether Vorys leans left of center, but they didn’t become the largest law firm in Ohio by forwarding a political agenda over correctly interpreting the law.

Of course, whether Controlling Board action is constitutional or not, this move by House Republicans further complicates and clouds the issue, not to mention it makes the debate (and the media surrounding it) that much messier.  Taking action on Medicaid Expansion at the Controlling Board has resulted in bad press all around for Republicans throughout the state, and as we’ve said before, it just isn’t the right move—such a huge policy deserves scrutiny at the legislative level.

But let’s be honest: that just was not going to happen.

Legislative leaders, particularly in the Ohio House, were never going to let Medicaid Expansion come to a vote.  I don’t know if that decision was based in 100% ideological opposition to any discussion on the issue, or fear that it would actually pass.  Regardless, the debate needed to happen in the legislature for one reason and one reason only:

Medicaid Expansion seems destined to happen.

It could have happened with legislative input.  It might happen through Controlling Board action.  But make no mistake about it, if both of those venues fail, Medicaid Expansion will happen if it goes to the ballot next year.

Ohio’s biggest hospitals are spending big to make sure that this issue makes it across the finish line—including a push to get it on the November 2014 ballot—and they want it to happen in its most liberal form.  Initial polling already puts the issue at 63% support, and the emotional arguments you can make in a 30 second commercial would be incredibly difficult to counter in an electoral campaign.  And if the debate over Senate Bill 5 taught us anything, it’s that big dollar interests have no problem pulling on voter heartstrings, even if what they’re saying is intellectually dishonest.

To recap, the proponents have big money, they have a huge early lead, and they have emotion on their side.  That’s all but unbeatable in a ballot campaign.  So, whether you want it or not, Medicaid Expansion seems destined to happen sooner or later.

Given that, it has always been in the General Assembly’s best interest to take up this issue.  At least then they would have had some control over how the expansion would have been implemented.  But it’s been ten months and not one Republican proposal surfaced in any serious fashion to deal with the issue.  And with signatures being gathered to place it on the ballot, the clock was running out for legislative action.

We may not agree that the Controlling Board is the best route, but at least it gives Ohio some small amount of control in the debate, as the spending would only be authorized for three years (after that, the federal funds phase down to 90% and legislative action would be constitutionally necessary to fund the other portion).  And it stops a more liberal form from coming to the ballot, keeping a potential liberal voter-turnout issue off the ballot as well.  In that regard, it was certainly a better maneuver.

I just wish leaders in the General Assembly would have had the debate instead.

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Third Base Politics is an Ohio-centric conservative blog that has been featured at Hot Air, National Review, Washington Post, Los Angeles Times, Pittsburgh Tribune-Review, and others.


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