COLUMBUS, Ohio — As a Republican chairman of the House Budget Committee in the 1990s, John R. Kasich wielded a ferocious budget ax. On Monday, as Ohio’s governor, Kasich defied his party’s majorities in the state Legislature to push through a multibillion-dollar expansion of Medicaid under President Barack Obama’s health care law.
By a 5-2 vote, an obscure committee, the Controlling Board, which normally oversees relatively small adjustments to the state budget, accepted $2.5 billion in extra Medicaid funds from the federal government. The money, recently approved by Medicaid administrators in Washington, will provide coverage for 275,000 Ohioans who have not been eligible for the program, the Kasich administration said.
The vote was an extraordinary — and possibly illegal, critics in Kasich’s own party said — end run by the governor around the General Assembly.
Kasich, who initially declared himself an opponent of the Affordable Care Act and who has declined to set up a state online health insurance marketplace, has argued all year that his sense of Christian compassion, not to mention cool economic practicality, favored extending Medicaid to poor adults and those with disabilities who do not currently qualify.
But Republican majorities in both houses of the General Assembly blocked expansion. Opponents expressed disbelief that Washington would keep its promises under the health care law to pay almost all of the costs of expanding Medicaid, the joint federal-state health insurance program for the poor, and worried that Ohio taxpayers would have to pay.
A budget sent to the governor by the General Assembly forbade Medicaid expansion without lawmakers’ approval. Kasich vetoed that item. At least three bills to expand Medicaid have failed.
Kasich, who has championed job creation as he prepares for a re-election campaign next year in his swing state, has argued that expanding Medicaid eligibility will be an economic booster shot, because companies will be lured to Ohio by a healthier workforce. Expansion is supported by state hospitals, the County Commissioners Association of Ohio and the Ohio Chamber of Commerce.
Under the Affordable Care Act, low-income workers are to receive federal subsidies to buy insurance starting in 2014. But there is a “coverage gap” for some who earn less than the poverty level but do not currently qualify for Medicaid.
The federal law allows states to expand Medicaid eligibility to people with incomes of up to 138 percent of the federal poverty level, about $15,860 for an individual. The 2012 Supreme Court decision that upheld the law also allowed states to opt out of Medicaid expansion.
With Monday’s vote, Ohio became the 25th state plus the District of Columbia to expand Medicaid, according to the Kaiser Family Foundation.