A number of sources are reporting the the Ohio Department of Job and Family Services will make a request to accept the federal funding for Medicaid expansion.

So, hooray!

The request will be made to the Controlling Board1, a bipartisan panel that handles limited adjustments to the state budget.   Here’s a quick primer…

What is the Controlling Board? The Controlling Board is a seven member panel consisting of “the Director of the Office of Budget and Management or an employee of the Office of Budget and Management designated by the Director, the Chairs of the Senate and House Finance Committees, a majority member appointed from both the Senate and the House, and a minority member appointed from both the Senate and the House.”

The panel is authorized to make limited changes to the state’s operating and capital budget as well as providing oversight in other areas such as the approval of certain grants and lands, approving certain land sales or purchases, approving tax incentives and  authorizing the waiver of competitive bidding requirements.

Expanding Medicaid is a much bigger deal than any of those things

Yep.  If the board takes up Medicaid expansion, as it is expected to do soon, it appears to be one of the largest requests the board has ruled on in its 98-year history. More importantly, expansion through the Controlling Board will most certainly result in a lawsuit by anti-Obamacare folks like Maurice Thompson at the 1851 Center.

If the lawsuit results in an injunction, it could mean that you still couldn’t enroll in Medicaid.

I suppose, on its face, it seems like “ODJFS requests to the Controlling Board that it receive federal funds” would fall within the powers of the Controlling Board. Since Medicaid expansion doesn’t cost the state money until 2017, then this path would work until then.

So we still need legislative action.

Yes. While I’m glad that people will get cost-saving benefits on January 1, I’d also like people to get those benefits (and Ohio to get those cost-savings) in 2017.

What if Ohio gets the money, but isn’t authorized to spend it?

In order to change the Medicaid qualifications, ODJFS must file an 1115 waiver with the federal government. The 1115 waiver says “we want to disobey the original Medicaid charter in such-and-such a way”. In this instance, it says “we want to allow people with incomes below 138% of poverty to enroll in Medicaid”. That waiver was recently approved.

Anything else?

Kasich’s original budget request was actually very complicated. It would have made Medicaid a cabinet-level agency, whereas this plan keeps it housed within Job and Family Services.   As a result we could find ODJFS and its Medicaid division differing in one important fashion: Medicaid will err on the side of enrollment, while the rest of ODJFS will err on the side of rejection. That is, it costs public money if qualified Medicaid applicants are rejected (because they’ll get private insurance and a larger subsidy than the cost of Medicaid) so it’s fiscally irresponsible to reject applicants.

Since reorganization doesn’t seem to fall within the Controlling Board powers, we’d have an inefficient structure. (edit: it seems that Kasich succeeded at getting Medicaid split from ODJFS. Good!)

Also, we’d still need legislative approval before 2017.

Why do this, then?

If there aren’t injunctions, then Ohioans will be able to enroll in Medicaid on January 1. That will vastly improve the quality of life for 1 of 20 Ohioans.

For Republicans, the big upside to the Controlling Board solution is that it protects the legislature from ever taking a vote on Medicaid. GOP legislators will be free to privately tell Tea Partiers that Medicaid is witchcraft, while privately telling Chambers of Commerce that they didn’t want to reject $13 billion that will be paid mainly to members of the Chamber.

It speaks volumes about the cravenness of the Republican caucus that they are so paralyzed by internal conflict that they’ve never even freaking debated Medicaid expansion. If you’re this conflict-averse, why get into politics?

Oh gawd.

For real. They have nothing to fear from Tea Party primaries! The primary is 4 months away. That isn’t enough time to organize existing support, create a campaign infrastructure from scratch, establish a narrative, and reach enough voters to unseat a well-funded incumbent.

The much bigger risk is that the many lunatics and psychopaths in Ohio’s legislature become obsessed with the Controlling Board and Medicaid expansion. Even though Kasich’s move protects legislators, the ginned-up Tea Party base will surely be outraged.

The path of least resistance is for legislators to nurture that outrage. If legislators turn on Kasich, they’ll be able to push through a bill to prohibit Medicaid expansion. After all, the budget sent to Kasich contained this language – but Kasich used his line-item veto to remove it.

The legislature can overturn a veto with only Republican support. When the budget was signed, they likely didn’t have enough votes. If opposition to expansion through the Controlling Board becomes part of the blood oath of the Tea Party, it will be harder for GOP leaders to avoid a tough vote.

After all, the past month has shown that Republicans will usually fall to the temptation to stoke the radical fire, then lack the temerity to keep it under control. And when they can’t legally change the law, they’re happy to shut down the government.

Unfortunately we still need legislative approval by 2017, midway through Gov. FitzGerald’s first term, but the legislature will still be controlled by, well, lunatics and psychopaths. If this move galvanizes legislative opposition, then we’ll be back at square one.

This seems lame.

It’s super lame. To paraphrase Chris Redfern, Kasich can’t convince his party leadership to simply hold a floor vote and he wants to be President of the United States?!?

The “both-sides-do-it” family of American journalism has long criticized Pres. Obama for failing to have the leadership to bring Republicans on board with a governing agenda. Kasich also can’t bring Republicans on board, and he’s a Republican.

It blows my mind that Kasich–the only one who’s in a competitive race–is unable to convince 11 Republican legislators that the business wing will protect them from attacks. After all, the Central Committee crushed the Tea Party candidate to chair the state party.

So, what’s the right wing going to do?

Good question. If I were they, nothing. Kasich has said for the better part of a year that he supports expansion, and now he’s putting his money where his mouth is.

Good for him2!

Of course, this also shows that Kasich is not the leader of the Ohio Republican Party. The legislature controls Kasich, and the loonies run the legislature. The Tea Party should be pleased with the status quo; if they take on Kasich and lose, they’ll lose their stranglehold on legislators.

I mean, they could get behind a Libertarian candidate and run ads against Kasich, but that would be a huge waste of money3. It would likely just depress turnout, and the Libertarian would probably need to pull a Perotian 15% in order to show Tea Party strength. They should just save their money, and then claim that Kasich was too moderate when he loses.

Besides, Kasich raised their taxes! If the Tea Party wants to be mad about something, they should be mad about that.


1 Somebody went back in time to 2015 to name them something that would drive Tea Partiers insane. I guess “The Illuminati” was taken. 2 Let’s be fair; I’d probably be critical if he didn’t do this. That said, we still need legislative action. 3 Just think of how many Planned Parenthood protesters they could hire with that money!