GOP plan could effectively kill John Kasich's Medicaid expansion

COLUMBUS - Ohio Senate Republicans want to freeze enrollment in Medicaid expansion starting next year – essentially killing the expansion – citing uncertainty about the future of health care in Washington, D.C.

The proposal, which was added to the state’s two-year budget Tuesday, would prevent new, lower-income Ohio adults from enrolling in Medicaid starting July 1, 2018. At that point, anyone who dropped off the rolls, perhaps because they received higher wages during a given month, would not be able to re-enroll.

Freezing Medicaid enrollment would essentially kill it within a year for many of the childless adults covered by the expansion, Gov. John Kasich's administration has said in the past. Right now, people jump on and off the program throughout the year, when seasonal work appears or disappears.

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Until July 1 of next year, people could continue to enroll and re-enroll in the program as usual.

“This freeze will help us evaluate where the budget is a year from now, and more importantly, perhaps, we’ll see what’s happening in Washington,” said Sen. Scott Oelslager, R-North Canton, who leads the Senate Finance Committee.

Kasich, a strong proponent of Medicaid expansion, could ax the freeze with a veto. It's not unlike a phaseout proposed by Republicans in the U.S. House, which Kasich opposed.

If it were to survive, Ohio lawmakers could adjust or eliminate the freeze later – or change anything else they do on health care – based on decisions made in Congress later this year.

Some Republicans still want to kill Kasich's expansion of Medicaid to lower-income Ohioans. They don't want to vote for a state budget that continues the Obamacare program, which provides insurance for more than 700,000 Ohioans.

As a compromise, House Republicans initially proposed a plan that would have required the Medicaid director to get approval for Medicaid expansion money every six months. To get the money, the director would go before the Controlling Board, a panel of six lawmakers and a Kasich appointee – the same group Kasich leveraged in 2013 when his party would not move the Medicaid expansion portion of Obamacare through the Legislature.

Senate Republicans eliminated that proposal Tuesday. They also eliminated the House's proposal for work requirements for those on Medicaid because of mental illness or addiction.

The debate over Medicaid in Ohio rages as Republicans in Congress craft an Obamacare replacement, largely in secret. Sen. Rob Portman, R-Terrace Park, has floated a seven-year phaseout of Medicaid expansion, starting in 2020, that would gradually reduce the federal money given to states.

Kasich might support a gradual end to federal money for Medicaid expansion, but he said a faster phaseout in House Republicans' plan fell "woefully short" of providing health care for Ohio's most vulnerable residents.

Kasich recently joined three GOP governors and three Democratic governors in a letter opposing the proposed Obamacare replacement.

In Ohio, Democrats opposed the Medicaid freeze proposed by GOP senators. 

"It's denying people valuable medical services," said Sen. Mike Skindell, D-Lakewood. 

The proposal from Ohio Republicans is part of the state's two-year budget, which is expected to pass the chamber Wednesday. From there, House and Senate lawmakers will combine their two plans. After that, Kasich can line-item veto items before signing the bill before July 1.