During the 2009 healthcare debate, Democrats accused Republicans of wishing that the elderly and sick would "die quickly" simply because they opposed the president's healthcare plan. The law, which takes healthcare decisions away from patients and gives them to politicians and cronies, is based upon imaginary budget numbers that the public never believed, and lets proponents sleep soundly imagining that by simply giving people an insurance card that American families will have access to appropriate, timely healthcare.
The American public saw through this charade and swept Democrats out of power and put Republicans like John Kasich into governors' mansions and statehouses. Governor Kasich's odyssey of pandering to special interests, demonizing opponents, denying math, magical thinking, and, ultimately, accepting the federal healthcare law's Medicaid expansion will work no better for him than it did for Democrats in 2010—and he will damage any effort to protect patients' rights and limit government intrusion into every aspect of our lives.
A new Quinnipiac poll shows that, by a 43-36 percent margin, Ohio voters believe Kasich deserves to be re-elected. This is a big change from December when the numbers were essentially reversed. In a vulnerable position, Kasich is clearly trying to shore up support and limit attacks from potential challengers. By pandering to the hospital and insurance lobby, who stand to reap billions under the Medicaid expansion, he likely closes the door on these groups using well-financed independent expenditures to undermine his re-election chances.
As with Obamacare, accounting gimmicks are required to support Medicaid expansion. The use and expansion of a "provider tax" to, in essence, launder healthcare dollars to get more federal money, is such an abusive practice that even President Obama has come out against it. Obama's proposed budgets the last two years supports cutting and limiting provider tax payments to save $21 billion dollars. With Republicans searching for any place where they can find common ground with the president on entitlement, it is likely this will be the starting point for any compromise.
Kasich, like Arizona's Jan Brewer and some other Republican governors, are touting a "circuit breaker," whereby, if federal dollars drop below a certain amount, the Medicaid expansion will simply turn off. Beyond the political absurdity of simply turning off an entitlement for over 600,000 Ohioans without any alternative policies available, the concept fails basic math. Given that Washington will send Ohio about $5 for every $1 the state must spend (this is actually even more unbalanced in the first three years), a circuit breaker that is hit after federal spending drops 20 percent, like the one being proposed by Brewer, means that Ohio Medicaid spending will need to increase 100 percent. Using Kaiser Foundation data from November 2012, this means that the predicted additional $6.6 billion in state spending would end up being much higher.
The argument that in the absence of Ohio expanding its Medicaid program dollars earmarked for Buckeye State residents will be spent elsewhere is patently untrue. The healthcare law sets state funding for Medicaid, and there is no clause that allows for more money to flow to other states in the absence of an expansion. Remember, Democrats were stunned that the Supreme Court, in a 7-2 decision, found the mandatory expansion unconstitutional. After the Supreme Court's decision, the Congressional Budget Office estimated that states choosing not to expand Medicaid will reduce government spending on the program by $289 billion, and, in the aggregate, reduce total spending by $84 billion.
All this would be bad enough were it not for the fact that pushing more people into Medicaid will not necessarily mean better, timelier care. A 2012 study published in the peer-reviewed journal Health Affairs noted that only 7 in 10 doctors are seeing new Medicaid patients in Ohio. And that is before an influx of 600,000 more—a 78 percent increase according to the Kaiser Foundation—will be added to the rolls. Proponents of expansion also ignore the data suggesting that, in many cases, health outcomes for those on Medicaid are far worse than private insurance and sometimes even worse than having no insurance at all.
Kasich has now begun demonizing anyone who thinks his plan is unwise or ill-fated. In his state of the state address on February 19, he engaged in the same straw man demagoguery as President Obama. Kasich accused anyone who had concerns as being uncaring, or worse. "What are we gonna do, leave 'em out in the street? Walk away from them, when we have a chance to help them?" Kasich asked.
Again, all of this would be bad enough, were it not for the fact that all roads to the White House for Republicans still lead through Ohio. All but those on the far left understand that substantive changes to our entitlement programs, especially Medicare and Medicaid, will be necessary to give our children the chance to carry on our country's greatness, instead of being left to pick up the pieces of a bankrupt nation. Does Governor Kasich honestly believe that adding another 600,000 people to an unsustainable, second-rate entitlement program will leave any opportunity for a Republican to come to Ohio and make a case for less government intrusion into nearly every aspect of our lives?
Governor Kasich has put his re-election efforts above fiscal sanity, patient autonomy, and the future of real pro-limited-government candidates. The significant Republican majorities in the legislature should demand answers, propose alternatives, call the governor and his allies out on their inconsistencies and lack of transparency—and make their case to the people of Ohio. Control over who gets to make healthcare decisions—patients or a bunch of nameless, faceless bureaucratic suits—is at stake.
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