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Medicaid Expansion And The Gubernatorial Race

The Republican gubernatorial candidate says he's had a plan to keep Medicaid expansion in the state. 

His Democratic opponent calls that a major about-face. The matter demostrates the high level of confusion surrounding this key state policy, and what either candidate will do if elected. Ohio Public Radio's Karen Kasler explains. 

Republican Mike DeWine says his plan has been all along to keep Medicaid expansion but with changes, saying that will include work requirements and wellness incentive and prevention programs. “There’s no change. What we have said, all along, that it had to be reformed,” DeWine said. “The people who, our opponents in this campaign say the only way is the status quo. We believe there’s a third way.”

But Democrat Richard Cordray calls that a flip-flop – and not the first one for DeWine on this issue. “He’s been against it all from the beginning. Now he’s saying that he’s been for the Medicaid expansion – this is at least his second or third position in this campaign alone,” Cordray said.


DeWine did indeed speak out against the Affordable Care Act, passed under President Obama in 2010. He filed suit against it on his first day as Ohio’s Attorney General. After the ACA was upheld, Governor John Kasich pushed for Medicaid expansion as allowed under the ACA over the objections of Republican lawmakers. Then, in 2013, Lieutenant Governor Mary Taylor was on board. But during this year’s primary for governor she was stridently opposed – and challenged DeWine in a Plain Dealer editorial board meeting in April.


The DeWine camp has said his criticism against Medicaid expansion was aimed at Taylor, saying that she supported Medicaid expansion before she was against it, and unlike Taylor, that DeWine was never on record saying he would eliminate Medicaid expansion. A month before the Plain Dealer editorial board interview, DeWine said in an interview on “The State of Ohio”: “If we get from the federal government the ability to design our own program, we will design that program, working with the General Assembly to take care of the problems that we have, but we’ve got to make some changes.”


Republicans also points to a claim that Democrats have made – that 26,000 Ohio children could lose health care coverage if Medicaid expansion is rolled back by DeWine. Jon Husted, DeWine’s running mate, said those in that population are low-income adults without kids. “There are no children covered under Medicaid expansion, which we felt was important to make the point today, since our opponent does not seem to understand how the program works,” Husted said.


Cordray is now backtracking from that specific claim, but says the overall concern stands. “That number was based on a study and a report on Ohio’s Medicaid expansion. And more to the point, if you start taking health care away from 700,000 Ohioans, it’s going to affect children, it’s going to affect families,” Cordray said.


DeWine says since he doesn’t know what the federal government might do in the future, so he can’t say how long he’d favor keeping Medicaid expansion. But he and Husted have said they feel the current system, without changes, can’t continue. “This is not just a Medicaid question. Our entire health care system costs too much and we have to do everything we possibly can to drive down the costs so that not only Medicaid is sustainable, but all of health care is sustainable,” Husted said.


But Cordray disputes the claim that Medicaid expansion is unsustainable. “[DeWine] is wrong on the numbers on that. Medicaid expansion, the federal government reimburses 96 cents on the dollar for Ohio – that’s a great deal, that’s a much better deal than the basic Medicaid program itself, which is more like 60-40,” Cordray said. “At its worst, on the current trajectory, it’ll be always 90 cents on the dollar. This is a good deal for Ohio.”


Whoever wins this fall will have to work with a Republican-run legislature has taken several steps to rein in Medicaid – for instance, putting a provision in the budget to freeze enrollment in Medicaid expansion. Governor John Kasich vetoed that, but lawmakers have until December to try to override that veto.


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