Ohio voters may decide fate of Medicaid expansion

A coalition including hospitals, insurers, unions, business groups and religious organizations has begun circulating a proposal for signatures and is targeting the November 2014 election.

The move comes the same week that Republican Ohio House Speaker William Batchelder, who has been vague on a legislative timeline, said the Ohio House won’t even convene until October, much less pass a Medicaid bill.

Republican Ohio Gov. John Kasich since February has pushed for Medicaid expansion. Some Republicans in the state legislature have resisted, citing concerns about the program’s cost, effectiveness and ties to the federal health care law, among other reasons.

The coalition’s proposal would expand Medicaid eligibility to people making up to 138 percent of the poverty line, bringing health coverage to an estimated additional 275,000 people. Under the federal health care law, the federal government would — starting Jan. 1, 2014 — cover the entire cost of expansion for three years before scaling support back to 90 percent, worth an estimated $13 billion over the next seven years.

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 and is the largest payer of nursing home care in the state. About 1.15 million children are covered by Medicaid.

John Palmer, a spokesman for the Ohio Hospital Association, said the signature-gathering doesn’t mean the coalition has given up on state lawmakers.

“From our perspective, it’s pretty much keeping our options open,” Palmer said. “I want to emphasize as I did during the state budget process that we’re supportive of a legislative resolution to this…But from our perspective, we’re just making sure that we’re responsive and doing our due diligence.”

To get the ball rolling on placing a Medicaid expansion issue on the ballot, the group needs to first collect 1,000 valid signatures from registered voters, which could happen by next week.

Eventually, they would need to gather 116,000 valid signatures, which would send the issue to state legislators. If the General Assembly defeats the bill or does nothing, the issue would be sent to voters.

Legislative work groups have been studying Medicaid expansion over the summer. As the debate has continued, Republicans have shifted their rhetoric from “expansion” to “reform” of the program to reduce the cost of Medicaid, including introducing spending caps, drug treatment and job training.

Batchelder spokesman Mike Dittoe said Friday that he’s “confident some significant Medicaid reform will be forthcoming.”

“But, assuming signatures would be gathered for the November 2014 ballot, it has been the House’s intention to move forward on Medicaid reform much earlier than that proposed timeline,” Dittoe said.

Asked if Kasich would support a Medicaid ballot initiative, spokesman Rob Nichols said: “We don’t care how it’s done, we just want it done.”

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