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Regulation and Compliance > Federal Regulation

Ohio panel gives final approval for Medicaid expansion

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COLUMBUS, Ohio (AP) — Thousands more Ohioans can soon enroll in the Medicaid program after a legislative panel on Monday cleared the governor’s request for the state to spend federal dollars to provide them with health coverage.

Ohio recently received approval from the federal government to expand Medicaid, the federal-state health program for the poor and disabled. However, Gov. John Kasich’s administration needed state legislative approval to spend federal money on an estimated 366,000 newly eligible residents.

The GOP-controlled Legislature has balked at Patient Protection and Affordable Care Act (PPACA) Medicaid expansion, so administration officials asked the little-known Controlling Board, made up of six lawmakers and an administration official, for the authority to spend $561.7 million in federal money this budget year and almost $2 billion next year on expansion.

The board signed off on Kasich’s spending request with a 5-2 vote.

Among the supporters was Republican Sen. Chris Widener of Springfield, who drew upon stories he said he heard from his constituents.

“I mean, these people are not wanting to be in Medicaid their whole entire lives,” he told reporters. “They’re working Ohioans. They’re Ohioans that need help for a little bit of time related to a health care issue.”

Kasich, a Republican, has pushed for Medicaid expansion since February. The GOP-controlled Legislature, in its opposition to the idea, has sought common ground on other Medicaid changes.

Wanting more people to be covered by January, the governor turned to the quietly powerful Controlling Board, where he would need fewer votes for the plan.

The panel — which handles certain adjustments to the state budget — consists of two Democrats, four Republicans and a Kasich appointee from the Office of Budget and Management. House Speaker William Batchelder replaced two Republican members of the legislative panel before Monday’s meeting. One replacement, Rep. Ross McGregor, R-Springfield, backed the request.

The board’s approval of expansion is likely to spark a lawsuit.

State Rep. Ron Young, one of more than 30 House Republicans who formally protested the Controlling Board request last week, said he expects to be among plaintiffs in a lawsuit being prepared by expansion opponents.

Maurice Thompson, executive director of the 1851 Center for Constitutional Law, said the group would argue in the suit that the board is violating the Legislature’s intent not to expand Medicaid. He said he plans for it to be filed within 24 hours of the vote.

“The act of the General Assembly in the budget bill was very clear,” Thompson told reporters. “It was a prohibition on Medicaid expansion and an appropriation of federal funds.”

Controlling Board President Randy Cole, from the Office of Budget and Management, described the administration’s request as “customary.”

The length of questioning showed otherwise.

Board members peppered Kasich administration officials from mental health, Medicaid and veterans services with questions about the issue for roughly two hours.

The request only allows the state to spend the federal money on the newly eligible Medicaid enrollees through June 30, 2015, the end of the current state budget. Then, additional legislative action would be needed to ensure that future federal funds continue to cover the expanded population.

Democratic Rep. Chris Redfern asked Kasich officials what assurances expansion supporters had that people would continue to get coverage.

Greg Moody, the director of the Governor’s Office of Health Transformation, said Kasich has made extending Medicaid coverage a priority.

“We do not make this decision to take federal money today and avoid responsibility in the future,” he said. “We make the decision to proceed under the terms of the federal law into the future.”

Medicaid already provides coverage to one of every five residents in Ohio and expansion is one of the key components of President Barack Obama’s federal health care law.

The board’s vote didn’t go unnoticed by the White House. Obama’s senior adviser, Valerie Jarrett, tweeted that she congratulated Kasich.

PPACA promises that the federal government will pay for Medicaid expansion for three years, gradually phasing down to 90 percent.

Medicaid expansion allows those making up to 138 percent of the federal poverty level, or about $15,860 for an individual, to be eligible for the program.

Many Republicans in Ohio are averse to PPACA and resistant to expanding government programs. They have cited concerns about increasing the national debt and fears that the money from Washington could be cut off.

Several Republicans on the panel asked what would happen if the federal government didn’t hold up its end of the bargain.

“If that deal changes, then we need to go back and revisit that deal,” Medicaid Director John McCarthy said.

AP Statehouse Correspondent Julie Carr Smyth contributed to this report.

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