Ohio may expand Medicaid through legislative sidestep

Ohio Gov. John Kasich, who has struggled for months to get a Medicaid expansion plan through a state legislature hostile to the Affordable Care Act, will likely perform an end run around lawmakers to get it enacted, the Cincinnati Enquirer reported.

Kasich plans to channel a request for Medicaid expansion through the Ohio Controlling Board, a seven-member body that handles funding requests from state agencies, including Ohio's Medicaid department. Kasich would need four votes, and two Republicans who sit on the board are expected to be replaced by individuals in support of the plan, according to the Enquirer.

Should the board approve the request, Ohio would receive $2.5 billion in federal funds over the next two years to expand Medicaid, according to the Cleveland Plain Dealer. The Centers for Medicare & Medicaid Services recently authorized Ohio to expand its program. Much of that additional money would go to hospitals, the article noted. A vote would likely take place on Oct. 21.

The board has handled controversial funding requests before. It approved Ohio's accepting of economic stimulus funds in 2009 after the Legislature balked at doing so.

Expanding Medicaid eligibility in Ohio would add about 360,000 uninsured low-income residents to its rolls. Ohio is the most populous northern state that has yet to enact Medicaid expansion, and the issue has become so heated that hospitals have been pushing a ballot initiative to put the question to voters. Kasich, although a Republican, has been supportive of the ACA.

Whether other states could use such a mechanism remains to be seen. About two dozen states have either refused to participate in Medicaid expansion or have yet to make a definitive decision.

To learn more:
- read the Cincinnati Enquirer article
- here's the Cleveland Plain Dealer article

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