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Ohio Medicaid expansion push down to the wire

Advocates are making an eleventh-hour push to get state lawmakers to expand Medicaid eligibility by the end of the month, even though Ohio legislative leaders have said they don’t plan to act on the issue until after their summer recess.

A coalition of businesses, mental health advocates and religious groups continued calls on Thursday for state legislators to expand Medicaid eligibility. They said not doing so will leave billions in federal money on the table while preventing 275,000 low-income Ohioans from an opportunity to receive public health care and exposing businesses to upcoming penalties for uninsured employees that take effect on Jan. 1.

The American Association for Retired People is distributing clocks to state legislators that say “time is running out for Ohio’s unemployed and low-income workers.”

“Failure to take advantage of the opportunity for Ohio’s citizens and employers would heavily disadvantage us to states that did complete expansion,” said Jeff Walter, a member of executive committee of the Ohio Chamber of Commerce.

Medicaid is a state and federally funded health care plan that covers 2.3 million low-income and disabled Ohioans, costs $19.8 billion a year, is the largest payer of nursing home care in the state and pays for 45 percent of the births in Ohio.

Expanding Medicaid eligibility up to 138 percent of the federal poverty line is a key portion of the federal health care law, also known as Obamacare. The federal government has said it will pay 100 percent of states’ costs of newly eligible enrolees for three years, and then gradually scale back to 90 percent*, an estimated $13 billion over seven years.

Earlier this week, Gov. John Kasich said he plans to continue pushing for Medicaid expansion.

“It will either be in the budget or it’ll be later,” Kasich said. “But I just want to make it clear: I will not give up this fight till we get this done — period exclamation point.”

Conservative Republicans in the state legislature have resisted expanding the program, tying accepting the money to the expanding federal debt, and expressing doubts over Ohio’s ability to get out of the expansion once it’s in, as well as concerns over the efficacy of the existing Medicaid system.

Ohio House Speaker Bill Batchelder, R-Medina, said Wednesday he doesn’t anticipate legislators will act this month on bipartisan bills that have been introduced in the House and Senate to reform Medicaid without expansion, and another house bill from state Rep. Barbara Sears, R-Lucas County, that would reform the program and expand eligibility.

The pro-expansion crowd has said they’ll begin steps to take the issue to the 2014 ballot if legislators don’t act by July 2.

“We’ll have some big decisions to make if we get to the end of next week and we’re disappointed because nothing has passed with respect to expansion,” said Jon Allison, a Republican lobbyist working with expansion advocates. “Certainly if there’s no sign or pathway to getting these bills passed, I think it’s a fact of life that somebody’s going to go to the ballot on this issue.”

If Medicaid expansion does end up on the ballot, Chris Littleton, who led the campaign for the successful anti-Obamacare state issue in 2011, said he thinks Ohioans will reject it.

“Yes, they are very deep pockets that can fund this. But the end result, I think, is going to be the end result of 2011, and that is people don’t want more government control of the health care system,” Littleton said.

* This sentence was corrected to reflect that the 90 percent match would be gradually phased in.

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