Dispatch Guest Column: Medicaid Reforms are Smart Financially & the Right Thing to Do

In this Dispatch guest column, the President of Ohio Right to Life explains why Ohio’s Medicaid reforms are a wise financial decision and the right thing to do:

Memo to tea party leadership: Average Ohioans, like average Americans, decided as long as 15 years ago that it is intolerable in a country as wealthy as ours for people, even poor people, to not have medical coverage and regular care.

That is why you are so out of step with Ohioans when you oppose Gov. John Kasich’s common-sense plan to take advantage of 100 percent federally paid Medicaid coverage for an estimated 275,000 poor, and in many cases sick, Ohioans, an estimated 75 percent of whom are working.

As a Republican, I don’t like Obamacare any better than you do. Like you, I worked to defeat Obama last fall. But we didn’t win. And we can’t let the philosophical opposition of the last election cause us to make a serious error in business judgment now.

By opposing this extension of Medicaid to fellow Ohioans, you put our state at serious financial risk.

And you also put the conservative movement at political risk.

Like it or not, Obamacare is now the law. One of the things it will do is to withdraw “ disproportionate share” payments to hospitals all over Ohio. This is funding the federal government has given for years to hospitals that provide uncompensated care to poor and indigent patients. The logic was that since the law expanded Medicaid, this disproportionate-share funding no longer would be needed. But the Supreme Court upset the Medicaid-expansion mandate, so Ohio now has the worst of both worlds: withdrawal of charity-coverage support for hospitals on one hand, and no program to replace it on the other.

Kasich has wisely put practicality at the forefront and proposed voluntarily taking the federal offer to expand Medicaid coverage, thus rebalancing the equation. Make no mistake, the failure to regain this balance will cause our major hospitals severe financial distress, weakening all of our health care.

I understand the emotional resistance to Obamacare. But this opposition to Medicaid expansion isn’t even smart politically.

While the reasons could be debated all day long, the fact is that the 275,000 Ohioans who would be covered under the Kasich plan are both poorer and sicker than average Ohioans. Some are victims of their own life decisions, but others are pushed to desperation by the ugly economic and job environment we now face. Most are working, but for very low wages.

Do tea party leaders really want to say “To hell with these fellow Ohioans”? Are you so bound up in ideology that you are willing to sacrifice the health of neighbors to that ideology, based on funding concerns that may or may not happen in five years? I know that the response is that your ideas of how to cover these people are superior. I agree, but we didn’t prevail. Are we going to say, “Wait four years while we get our act together and maybe win and maybe come up with a better plan?”

A similar kind of ideological, rather than compassionate conservative, response already has cost us the goodwill of the growing Hispanic community in America in the immigration debate.

In the Medicaid debate, Republican and independent women are among the strongest supporters of ensuring that all families have medical care. Do we really want to alienate this constituency in the same thoughtless way we turned Hispanics against conservatives?

Not this conservative. And, thankfully, not Kasich, who is fulfilling his duty to be governor of all Ohioans. His compassion, like his compassion for families facing autism and his compassion for poor kids with comparatively minor drug violations, describes for me what compassionate conservatism is about. He deserves support for this initiative.

You can read the original column here.

Dispatch: Gov. Kasich Visits Toledo to Urge Support for the Proposed Jobs Budget

Toledo1

Governor Kasich was recently in Toledo to attend the Lincoln Day Dinner and talk with Ohioans about his proposed Jobs Budget. The Dispatch has more below:

TOLEDO — It was a political event, but Gov. John Kasich was of no mind to talk politics.

Instead, he focused on policy last night in a 34-minute speech to about 500 people at the Lucas County Republican Party’s Lincoln Day Dinner, the first of six such county GOP dinners on his schedule through spring.

The governor offered a shortened redux of the State of the State speech he delivered in Lima on Tuesday night, urging the Toledo faithful to get behind his proposed $63.3 billion two-year budget, while unabashedly touting his administration’s achievements.

Kasich’s litany of successes included 122,000 jobs created and an $8 billion deficit turned into a $1 billion surplus without raising taxes.

“We now in Ohio have momentum,” said Kasich, who said his budget was crafted out of a “moral obligation” to create jobs.

The blueprint, however, has received a lukewarm reception from the legislature’s Republican majorities; members question his call to expand Medicaid to 275,000 more low-income Ohioans.

As he did in Lima, Kasich passionately appealed for support of the Medicaid expansion, saying that “the Good Book says you don’t ignore the least among you.”

Noting that the expansion would save Ohioans $400 million over two years and bring in billions in federal money to insure the working poor, Kasich said: “Abraham Lincoln did what’s right to lift human beings, and our conservative Republican Party must do the same.”

Toledo Mayor Michael Bell, a Democrat-turned-independent who attended the dinner, called the Medicaid expansion “extremely important … because most of those people who do not have any type of insurance end up in emergency rooms, and that type of treatment is much more expensive.”

You can read the entire article here.

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Editorial: Gov. Kasich’s Plan Makes Sense – Ohioans Should Support

State-of-the-State

In this editorial, the Dispatch explains why Ohioans should support Governor Kasich’s plans to cut taxes and reform Medicaid – both efforts to lead to job creation and stronger families:

In his State of the State address and in the budget proposal that occupied much of the speech, Gov. John Kasich has laid out a plan to sustain and accelerate Ohio’s economic recovery. That’s a prospect worth cheering for, but it won’t come to pass if an ideology-bound legislature stands in the way.

Kasich is taking heat from fellow Republicans for his plan to expand Medicaid using federal dollars. From Democrats, it’s flak over his proposal to lower state income tax and lower, but more broadly apply, state sales tax. This diverse chorus of complaints illustrates what sets Kasich apart from most politicians: He panders to no special interest but Ohio’s welfare. He works to solve problems, not play on a political team.

That will be no comfort to Ohioans if lawmakers reject his good ideas. Anyone who is putting Ohioans’ best interests first can see that expanding Medicaid under the federal Affordable Care Act is the right call.

This doesn’t suggest that the federal health-care overhaul is a good law; it isn’t. But it is, nevertheless, the law. Rejecting Medicaid expansion is not going to roll back the overhaul. So state officials’ obligation is to navigate it to Ohio’s greatest advantage. To do otherwise hurts no one except Ohioans. As long as the federal government is paying most of the cost, which it has pledged to do until at least 2020, expansion is the best deal. Kasich’s proposal calls for reversing the expansion if the feds stop covering the cost.

First and foremost, by extending Medicaid coverage to anyone earning up to 138 percent of the federal poverty level, it means that an estimated 275,000 low-income people will be guaranteed insurance coverage. The benefits accrue to everyone: People who can get preventive care won’t end up in emergency rooms with conditions that have grown unnecessarily serious and expensive. This lowers medical spending overall and eases hospitals’ burden for uncompensated care, which should help lower premiums for those who have insurance.

An economic study by four reputable groups attached some compelling numbers to the issue: the expansion would mean a net gain to the state of $104 million in 2014 and $1.4 billion by 2022.

Some state lawmakers object that the debt-laden federal government doesn’t have the means to fund this new entitlement. But that is an issue for federal lawmakers to grapple with. If state lawmakers turn down the $17 billion slated for Medicaid expansion in Ohio, the federal government will spend it elsewhere, and Ohioans will be worse off.

With his tax proposals, Kasich follows the sound economic policy of shifting the burden toward consumption rather than income. The sales-tax changes are not, as critics contend, a disproportionate burden to lower-income families. Some services that weren’t taxable before would become subject to tax, but the overall rate would be lowered to 5 percent from 5.5 percent, and housing, food and health-care spending would remain exempt.

Reducing income tax by 20 percent over three years, and even more for small-business owners, would give all Ohioans a break and put more money into the private economy, the ultimate source of wealth for the whole state.

As a candidate in 2010, Kasich was painted by opponents as an extremist conservative, but he has proven otherwise. He is a pragmatist who puts success ahead of ideology. Recession-weary Ohioans want lawmakers to do the same.

You can read the original article here.

Dispatch: Gov. Kasich’s Budget Offers Help for the Mentally Ill & Those with Addiction Problems

Governor Kasich’s recent budget proposal includes plans to make sure that Ohioans who are mentally ill or have addiction problems will get more help. The Dispatch has more below:

After struggling through years of cuts, mental-health advocates say that Gov. John Kasich’s budget would expand treatment, housing and other services for the mentally ill and addicted.

Much of the help is tied to an expansion of the tax-funded Medicaid program, to give health coverage to more poor and disabled Ohioans. Many of the uninsured who now receive locally funded services would become eligible for Medicaid, freeing an estimated $70 million a year that county officials could re-direct to housing, employment and other help.

In addition, the governor’s proposal would remove up to 1,200 mentally ill residents from nursing homes, providing them instead with community-based services.

“Some mentally ill people, not just those who are severely mentally ill, will get help and beat this disease,” said Terry Russell, executive director of the National Association on Mental Illness Ohio. He called the Medicaid expansion “the most-significant development in years for the people I represent.”

Kasich’s proposed 2014-15 budget also calls for increasing the rate paid to adult-care facilities for the mentally ill, now $16 to $28 per day, and consolidating mental-health and drug-addiction services to save $1.5 million annually and streamline services.

The House Finance Committee will hear testimony today about the plan from Greg Moody, director of the Governor’s Office of Health Transformation.

And

In addition to freeing up local dollars, Moody said, the governor’s plan would reduce costs associated with hospital emergency rooms, criminal courts and jail, places where those suffering from mental illness and addictions often end up when they have no access to services.

Franklin County officials say they would likely redirect local money to housing, prevention, education and outreach to reduce the stigma faced by those with mental illness and addictions and their families.

You can read the entire article here.

Column: The Jobs Budget 2.0 was Crafted to Offer Reforms that are Good for Ohio

Budget

In this guest column from the Plain Dealer, the author explains why Gov. Kasich’s proposed Jobs Budget 2.0 is both thoughtful and substantive. The goal is clearly to continue Ohio’s momentum, create jobs and offers reforms that are beneficial for Ohioans:

Any legislation encompassing taxes and spending of more than $60 billion is bound to generate controversy, and the quibbling over Gov. John Kasich’s proposed biennial budget has begun. Yet, however one may feel about any of its details, it ought to be clear that this budget is not business as usual. Indeed, it will be an achievement of historical importance, both for its substance and its break with the hyper-partisanship of recent years — if it gets through the General Assembly largely intact.

It is hard to imagine a document that better represents the much ballyhooed “balanced approach” that has been so elusive for national leaders the past several years. This balance spans the budget’s major components, beginning with real tax reforms. While lowering income tax rates for families and small businesses — sure to appeal to most conservatives but highly suspect to many liberals — it also increases business taxes on oil and gas extraction, which runs counter to a four-decade-long trend of higher burdens on families and lower taxes on business. More significantly, it reduces the rate of the sales tax while expanding its base, extending the tax to several long-excluded service industries. These are reforms touted by policy analysts from across the political spectrum.

In the field of education, primary and secondary schools would benefit from more lottery and general-revenue-fund subsidies, and the distribution of funds will more effectively assure fairness. While the first-blush praise from some education leaders has faded as details for their own districts have become known, by focusing on decades-long inequities, the proposed budget constructively frames the legislative deliberations that began last week. Similarly, the more modest increases in funding for higher education are accompanied by changes that would base state support less on body counts and more on degree completion.

In the health care arena, the administration’s proposals are extraordinarily comprehensive and forward looking. Most significant is the decision to proceed with expansion of Ohio’s Medicaid program. Providing health benefits for low-income workers and their families will benefit well over half a million Ohioans. Covering low-income individuals — many of whom have significant behavioral health problems or chronic diseases — will vastly improve the lives of some of the poorest and most severely ill Ohioans. In combination, the expansion should relieve providers, businesses and the privately insured of most of the cost of uncompensated care, making complex and dysfunctional cost shifting a thing of the past. Further, streamlined eligibility determination promises to reduce bureaucratic snafus and ridiculous difficulties for families negotiating their ways through the public welfare system. Creation of a single cabinet-level Medicaid agency — proposed to, and ignored by, previous governors of both parties — promises to strengthen management of the largest program in state government. The concurrent consolidation of mental health and alcohol and drug addiction service agencies will allow the same during a period when access to and funding of behavioral health services will undergo unprecedented expansion.

Beyond the broad outlines of the Medicaid expansion, the attention to details is noteworthy. For example, payment reforms will focus more attention on improving health, preventing disease and managing expensive chronic conditions that drive so much of health care cost. Additionally, directing Medicaid’s graduate medical education support to primary care professions and away from subspecialties is a bold first step in addressing the undersupply of general practitioners and oversupply of subspecialists. The administration’s effort to reach out to the Obama administration to explore covering a portion of the newly-covered through subsidies to private insurance is a groundbreaking alternative that might set an example for other states that are reluctant to move forward with the Affordable Care Act. And finally, the proposed trigger mechanism aborting the expansion if the federal government fails to fulfill its financial commitments provides assurance that future state leaders will not get hammered with enormous unfunded federal mandates.

Taken as a whole, Gov. Kasich’s executive budget reflects both pragmatism and principle. It is broad in its reach and extraordinarily thorough in its detail. It bears the stamp of the governor’s conservatism throughout, but borrows from the political left where he sees a benefit for Ohio. It is, in a word, balanced.

As with all legislation, the budget will be the subject of hundreds of amendments, which is business as usual. But this is decidedly not a business-as-usual budget. Nor is it doctrinaire. The thoughtful combination of its major provisions gives it an integrity that is far from the norm. It is a combination worth fighting for as a piece, and the governor should not hesitate to call on Ohioans to make their voices heard if it starts to unravel.

You can read the original column here.

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