“Which Members of Congress Want to Cut the Medicaid Match for States?”   That’s the follow-up question every reporter should ask state legislators about Medicaid.

The main complaint coming from Ohio Republicans about expanding Medicaid through federal dollars is that the federal match (FMAP) – currently set at 100% for the next three years and shifting to 90% by 2020 –  “isn’t set in stone” and its future removal would hurt Ohio.

That’s malarkey.

1.  The only reason it isn’t set in stone is that we don’t write our laws on stone tablets.  It’s law.  What they’re afraid of is that a future Congress will change the law.

2.  Republicans members of Congress aren’t suggesting we reduce the FMAP.  Indeed, they say the Ryan plan will increase state support!  And certainly, Democrats in Congress don’t want to eviscerate Obamacare*.  So neither party has any public plans to reduce the federal share.

3.  Just as Congress can change the law, so too can a future General Assembly change Ohio law.  If the federal government reduces the federal payment, then Ohio can repeal the expansion.  Indeed, it’s what makes FMAP reduction a bad policy.  One would hope that this future General Assembly would lobby against a future FMAP reduction on precisely those grounds.

4.  If future Republicans want to reduce the FMAP, tell them not to.  If only the Ohio Republican Party knew a powerful Republican congressman!

The Republicans are trying to have it both ways on this.  The Ohio GOP is saying “we can’t expand Medicaid, what if they block-grant it?” while the federal GOP is saying “we need to block-grant Medicaid because that will be awesome for the states”.  Both of these statements can’t be true simultaneously.

When the press lets state legislators to give that answer, they’re being enablers.  If the GOP wants to cut FMAP, they need to say so–and pay the political price.  If they don’t, then there’s no reason to oppose Medicaid expansion.**


The Buckeye Institute is all up in arms over this Heritage Foundation paper from 2012, which (spoiler alert) is misrepresenting the situation.    According to the report the “Obama administration” supposedly floated the idea of setting a single, blended FMAP (they’re currently set for each program) which is “true” insofar as it was in the Simpson/Bowles report and Simpson/Bowles was “part” of the Obama administration.  The Centers for Medicare and Medicaid Services (CMS) No Longer Support a Blended Matching Rate.   Both the Buckeye Institute and the Heritage Foundation have been invited to participate in a panel on Medicaid expansion in Ohio with the Ohio House of Representatives.


** Well, I suppose there’s still this reason.