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Friday, April 12, 2013

"Kasich Veering Left" and Medicaid

John Fund’s column at National Review Online reports on Gov. Kasich’s efforts to expand Medicaid in Ohio: 
Most political observers in Ohio believe Governor John Kasich wants to run for the Republican nomination for president in 2016. If that’s true, he’s approaching it in an odd way, alienating much of his conservative base by making controversial tax proposals and proposing to expand Medicaid — although he now appears to have given up on the latter.. . .  
This week, the GOP-controlled state house stripped Kasich’s Medicaid expansion out of the budget, rewrote his school-funding formula, canceled all of his tax increases, and reduced his income-tax cut to 7 percent for all taxpayers.. . .  
In reality, giving in to the lure of “free” federal dollars to broaden Medicaid isn’t compassionate. Over half of physicians no longer accept Medicaid patients because it is a failed program with bargain-basement reimbursement payments and bureaucratic regulations that lower the quality of overall care. “Medicaid patients often give up trying to find a doctor and wind up in hospital emergency rooms, where they wait three to six hours for non-urgent care,” John Goodman of the National Center for Policy Analysis told me.  
Representative Chris Collins, the chairman of the House’s Small Business subcommittee on health, told me, “The false promise of Obamacare’s Medicaid expansion is that it will trap millions of Americans in a program that needs urgent reform first.” Recent studies by the University of Virginia have shown that surgical patients on Medicaid are 13 percent more likely to die than those without insurance of any kind.  
But hospitals — among the biggest employers in Ohio — lust after the $13 billion in federal Medicaid dollars that would flow to Ohio over the next seven years. Hospitals helped bring 2,500 liberal protesters to the state capital of Columbus yesterday to argue for Medicaid expansion. With Kasich insisting he “profoundly disagrees” with the legislature’s refusal to expand Medicaid, he may well ratchet up pressure on the legislature. 
That’s what worries many Republicans. “We are dividing ourselves on a core issue,” says Tom Zawistowski, a Tea Party leader, who is running against the governor’s choice for Republican-party state chairman later this month. He notes that 65 percent of Ohio voters supported an anti-Obamacare initiative in 2011 and at least two-thirds of Republican primary voters oppose Medicaid expansion. “Political analysts like Charlie Cook say Obamacare’s failures could be the big issue in the 2014 midterm election, and we are just fracturing our coalition here,” he told me. 
On policy grounds, GOP house speaker Bill Batchelder says that Medicaid expansion would be a leap into the dark. “This is so screwed up,” he told the OhioCapitalBlog. “We have all these regulations that have to come out. . . . We also have to know what it means if they don’t have the money in Washington.”
 If they don’t have the money in Washington? As the late Prime Minister Margaret Thatcher famously said: “The trouble with socialists is that they always run out of other people's money.”

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