Obamacare and GOP Governors – Is This a Tipping Point?

Gov. John Kasich's choice to expand Ohio's Medicaid program may provide political cover to other Republicans who have vehemently opposed the Affordable Care Act.

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Joshua A. Bickel / Corbis

Ohio Gov. John Kasich addresses the crowd during a campaign rally with presidential candidate Mitt Romney at Port Columbus International Airport in Columbus, on Nov. 5, 2012.

This post was updated at 2:20 p.m. on Feb. 6, 2013

Opposing the Affordable Care Act appears to have gone from a principled stance to an impracticality for some Republican governors. In a move drawing fierce criticism from some conservatives, Ohio Gov. John Kasich (who campaigned in 2010 on a platform that included denouncing the health care law) announced on Monday that he supports a vast expansion of his state’s Medicaid program, made possible by the ACA, that could bring new insurance coverage to millions of Americans nationwide. Then Wednesday, Michigan’s governor, Republican Rick Snyder, followed suit. In total, six Republican governors have now said they will participate in Obamacare’s Medicare expansion.

Because he had been so critical of the ACA in the past, Kasich’s decision could provide political cover for other Republican governors who may be considering similar expansions of Medicaid, which is a joint state and federal program. Under the ACA, states that open Medicaid to everyone earning up to 133% of the federal poverty level ($14,856 in 2012 for a single person) will receive 100% federal funding for newly eligible enrollees initially, phasing down to 90% by 2020. (Most states now receive a far smaller federal match for Medicaid beneficiaries.) Kasich said it “makes great sense for the state of Ohio.”

Still, Kasich’s decision, presented as part of his latest budget that now goes before the state legislature, was surprising. He joined more than 20 other states that sued to overturn the ACA back in 2011. After the U.S. Supreme Court upheld the constitutionality of the health care law but said the Medicaid expansion specifically should be optional for states, Kasich issued a statement saying that he was “very concerned that a sudden, dramatic increase in Medicaid spending could threaten Ohio’s ability to pursue needed reforms in other areas, such as education.”

Philip Klein, a conservative writer for the Washington Examiner, says Kasich’s Medicaid decision is “political cowardice” and “a demonstration of how difficult it is to defeat big government.” An editorial in the Wall Street Journal titled “The GOP’s ObamaCare Flippers” accused Kasich and the other GOP governors of accepting a federal “bribe” by signing up to take the generous federal matching funds for expanding Medicaid. The Ohio affiliate of the conservative group Media Trackers said Kasich’s Medicaid cave “means a total collapse in Kasich’s credibility on Washington spending.”

Some Republican governors have said they won’t expand Medicaid, while others are still undecided. On Tuesday, Pennsylvania’s Republican Gov. Tom Corbett said he opposes an expansion of Medidcaid in his state. There is no deadline to sign up for the program, but governors across the country have been under tremendous financial pressure from health care providers in their states who would benefit from enlarging Medicaid. Hospitals now provide charity care to residents who would qualify for Medicaid if it were expanded to ACA levels. Under the law, the federal reimbursements these hospitals now get for providing the free care will gradually decrease, leaving these facilities in the lurch without new Medicaid-covered patients to make up the difference.

18 comments
stephenowensmith
stephenowensmith

The uninsured use emergency rooms and the rest of us with insurance have to pay for their care. The ACA spreads the cost and will have the effect of reducing individual insurance policy costs. Everyone will use medical care at some time, when everyone has insurance it is possible for everyone to pay the bill when necessary. “Things could get grim for the industry if Republicans succeed in repealing the Affordable Care Act's subsidies and mandates, but leave standing its requirement that insurers cover people with health problems. If that's the outcome, the industry fears people literally could get health insurance on the way to the emergency room, and that would drive up premiums.” RICARDO ALONSO-ZALDIVAR | Associated Press.

DonnyDarkoh
DonnyDarkoh

Pushing the Affordable Care Act would become impractical for politicians if enough people opted out and adjusted tax refunds so they wouldn't suffer the so-called mandate penalty.  Personally, Affordable Care seems 100% unaffordable to me, and I'm just gonna keep my cash and go judgment-proof.  I don't want all their so-called preventative health-care services anyways.

nflfoghorn
nflfoghorn

Republicals, led by our dunce of a gov in FL and his attorney general, did their darndest to torpedo Obamacare and failed.  They have no choice but to follow the law.  Poor ol' RiP will try to buck the trend but, as Ob pointed out, it's one facade in public and another in private. 

KevinGroenhagen
KevinGroenhagen

"Kasich’s decision could provide political cover for other Republican governors who may be considering similar expansions of Medicaid...."

Given the criticism Kasich is receiving, it's not likely. 

bobell
bobell

As Deep Throat said in the movie (not in real life): Follow the money. The feds are paying the states to increase the availability of health care.  The hospitals are going to see a major increase in compensation for treating indigent patients.  It's like the stimulus: the right-wing governors complain that it violates federalism and won't work, but they take the money anyway -- because (1) the money's there for the taking and (2) it really does work.

Can you spell "hypocrisy"?

Paul,nnto
Paul,nnto

I'm guessing that Kasich isn't overly concerned with name calling by a free newspaper's columnist (The Examiner) and the Wall Street Journal editorial which never took a position that surprised a soul. 


bobcn
bobcn

Yet another health care article that only talks about a few people's political ambitions - not about actual health care for people who need it.

Is the political gamesmanship of Ohio's governor really more important than the health of Ohioans? Wouldn't an article that compares the impact of applying the ACA's changes for Ohioans versus not applying them be more useful? 

HarryKuheim
HarryKuheim

@stephenowensmith  And where are these people who use the Emergency Room as their Doctor going to come up with the Obama Care Premiums?...they won't...YOU will subsidise it for them...so what's the difference?

mcrow
mcrow

In other wods, you intend to steal health care services by ensuring you won't be able to pay the services you know you will need eventually, because you won't even take cost-effective measures to stay well. Immoeal idiot!

Libtards-UNITE
Libtards-UNITE

@bobell The governors that took the money, did so because it's actually revenue paid by the citizens of their state, not because they believed in the plan.  You libs forget that it's not the government's money.  It's the taxpayers money.  Can you spell 'duh'?

MrObvious
MrObvious

@bobell 

Principles in the trashbin/table/in front of voters

Cash under the table.

That's how Mr Goodhair have survived and roll.

doddeb
doddeb

bobcn:  I for one would appreciate an article on the impact, since I live in Ohio.  I know that ACA means that my mentally ill brother will be eligible for medical insurance for the first time in his adult life.  So, yeah, I'd like to know some details about how it will work, versus whose political ox is being gored.  Have to say though, it's nice not to be embarrased by the stupidity of my governor, for a change.

wandmdave
wandmdave

@HarryKuheim @stephenowensmith The difference is with insurance they will see the doctor for cheaper routine care instead of waiting to get far more expensive emergency care at the ER because they have no other choice.

I don't know about you but if I'm paying either way I'd rather pay for the cheaper stuff.

biffula
biffula

@HarryKuheim @stephenowensmith Exactly.  And the catch is that (surprise, surprise) the numbers of those that are going to need their insurance paid for by the federal govt. is going to be much, much larger than what Pres. Zero lied to u with.  Not 10-20 mil., but more like 50-75 million!!!!   This poorly thought out socialist program is going to destroy the U.S. when coupled with the already astronomical debt service.  

bobell
bobell

@Libtards-UNITE @bobell As far as the governors are concerned, it doesn't matter where the money comes from.  It matters where the money goes. The money goes to their states, where it buys health care for the citizens and supports jobs in the healthcare industry.

And it is the government's money.  The government takes it from the taxpayers, or borrows it, and then spends it.  Is your salary your employer's money (assuming you're employed) after you've received and deposited your paycheck?

Stop with the bullpuckey and face the facts.

bobell
bobell

@Libtards-UNITE @bobell Rusty (Who else?) --

You don't seem to understand that you're agreeing with my basic point -- the money's there for the taking, so the governors really have no choice but to take it. So much is objective fact. You then attribute all sorts of nasty motives to Obama and the feds -- and maybe to the governors as well; at the volume at which you rant it's hard to tell exactly what you're saying.

Again -- Try to sort reality from rhetoric.  You seem for once to have a grasp on what's happening; you simply have no idea how to react to it.

Libtards-UNITE
Libtards-UNITE

@bobell @Libtards-UNITE The fact is, you are a libtard and believe that the government owns your life.  Yes, the tax revenue is intended to provide certain services and such for the taxpayers.  You imply that the governors only take the money because they secretly agree with the plan or because they are on the take for free stuff.  The money was taken from the state to provide government service.  Refusing the money, no matter how crappy the service is would be an injustice....on reason being because the government just take that money that they refused and waste it somewhere else.  Wake up you half-wit and smell the government issue coffee.