Ohio Gov. John Kasich is a master at taking bows for work others performed. His first glaring example came back in the 1990s, when he took credit for revenues that helped balance the federal budget and grow positive cash flow [viz. the surplus] under President Bill Clinton, even though the middle-aged congressman voted against the very measure that produced those robust revenues because a slight rise in taxes for the wealthiest was involved.

After first elected governor in 2010, he took credit without shame for tens of thousands of jobs former Democratic Gov. Ted Strickland created before leaving office that put the state on the road to recovery from a long and deep national recession Kasich’s president at the time, George W. Bush, created with help from allied Congressional Republicans.  Earning heft paydays as a Wall Street for Lehman Brothers and host if a Fox TV political talk show, Kasich failed to utter one word of protest about trillions in income tax giveaways or profligate spending for a war based on political convenience.

His most recent example came last week in a report on Ohio’s 2014 Medicaid expansion. The master was at it again, this time crowing about the improvements hundreds of thousands of poor Ohioans have received through the expansion of Medicaid, the federal-state program for healthcare for the poor. Team Kasich conveniently and completely ignored the fact that, but for President Barack Obama and a Democratic Congress passing the Patient Protection and Affordable Care Act [ACA] in 2010 without a single vote from Congressional Republicans, health and financial hardships for the state’s poorest would still be a giant problem for them, the healthcare industry they accessed principally through emergency room visits, and state coffers that paid providers for their services.

The ACA, or Obamacare as Republicans re-named it to demonize it, which even the conservative-leaning U.S. Supreme Court ruled constitutional, allowed for health care coverage for people with incomes up to 138 percent of the poverty line. Recall that the ACA regulated and subsidized the individual market, and that it was Chief Justice John Roberts who gave states the option of accepting Medicaid expansion, 19 of which declined to participate. Ohio is among the 31 states that agreed to participate, due to Gov. Kasich’s administrative end-run around a GOP legislature at odds with him.

The number of Ohioans now using Medicaid so far is about 702,000, according to reports about the governor’s latest disclosure on Medicaid expansion, which fulfills a request from the General Assembly. Mr. Kasich is a fan of government spending even though he rails against it, so when $2.5 billion was dangled in front of him as Ohio’s take from Washington, he wasn’t going to turn it down despite his classic and constant grumbling about balanced federal budgets. To the contrary, manna from DC in the form of billions for Medicaid expansion was funding Team Kasich could use to “reform” current programs so the now-freed up state revenue could be piggy-banked to give away in the form of income tax cuts, a favorite top-tier redistribution goal.

Being the former Washington insider he sold himself as during his unsuccessful run for president this year, John Kasich knew the big bills would come after he left office, so participating in the early years when Washington would foot 100 percent of the tab was political math 101. Current law commits the federal government to pay 100 percent of costs of newly eligible beneficiaries this year. Ohio’s Medicaid roll is now more than 3 million, up from 2.4 million just last year, which in its own way is a reflection of how poorly Gov. Kasich has provided good-paying jobs for his residents.

Medicaid expansion was made possible by the Obama Administration and has improved the lot of uninsured poor working-age adults even though it took a terrible toll on the president, his party and its candidates over the last eight years. Still, in spite of the political fallout, Medicaid expansion has pushed the uninsured rate among this group down to 14 percent, the lowest ever reported.

Kasich basking in the good news from the big drop in Ohio’s uninsured poor hides his constant berating of those whose economic uncertainties have pushed them toward “dependency” on government programs, primarily because their incomes are not sufficient to allow them to meet their needs without resorting to social safety net programs like food stamps or Medicaid.

Meanwhile, adding to the problems manifested in a rise in poverty under Gov. Kasich is his under-performing the national job creation average for all but one month out of the last 48. Lack of jobs, or the mostly low-paying ones created on his watch, have made expansion of Medicaid the medical miracle everyone who forced to turn to government because they can’t turn to their own employer for higher wages thankful for.

Team Kasich’s report on Medicaid expansion notes the following highlights:

• 75 percent were uninsured before becoming eligible for Medicaid

• More than 1 in 4 has been diagnosed with at least one chronic condition, most commonly high blood pressure or high cholesterol, and including 2 percent with cancer

• About a third suffered from depression and anxiety disorders

• 32 percent were diagnosed with substance abuse or dependence

It is certainly juicy political irony that new enrollees typically are unmarried white men with a high-school diploma or less, or the very people—of which 43 percent were without a job—who voted for Donald Trump for president. As their reward, Donald Trump’s vow to repeal Obamacare creates tremendous uncertainty for them again. It’s also noteworthy that Trump trounced Kasich in the GOP primary, then went on to win Ohio over Democratic president nominee Hillary Clinton by nine points.

To add injury to insult, Ohio’s per capital health care costs are above the national average. The 2015 Health Care Cost and Utilization Report finds big gaps in the prices of medical procedures from city-to-city and state-to-state, based on actual claims data from some of the nation’s largest health insurers.

Information in the report that looked at spending in 18 states shows Ohio’s per capita spending was $223 higher than the national average of $5,141, with cost of deductibles, co-pays and other out-of-pocket costs at $886, also higher than the national average of $813.

Transparency in health care costs have always been opaque. What won’t help are efforts by special interests in Ohio to block a new law that would mandate price disclosures to patients before they’re provided non-emergency treatment. Think about it in everyday terms, like ordering off a fast-food menu without prices. The combo meal might cost $15 in Columbus even though the price in Cleveland might be $5.99. Instead of A meal, how about triple-by-pass surgery? It would help to know up-front costs for procedures instead of having a heart attack later when the bill arrives, and now you’re facing bankruptcy to pay for it. As usual when it comes to big, important issues, the Kasich administration declined to comment, saying it “doesn’t talk about pending litigation.”

The anti-transparency special interests Gov. Kasich could go after, like he likes to do with public union workers, who are suing the state over the bill include The eOhio Hospital Association, Ohio State Medical Association, Ohio Psychological Association, Ohio Physical Therapy Association, Ohio Chapter of the American Academy of Pediatrics and others.

Ohio’s Republican-led legislature has in the past voted to not expand Medicaid coverage. Now, with a new high majority in both the House and Senate, if it decides to do so again, and Gov. Kasich vetoes their will, they just might show him who the real boss is by overriding his veto pen. If President Donald Trump and his GOP-controlled Congress doesn’t do it, Ohio’s lawmakers could finish the job, and neither Democrats or Gov. Kasich’s veto pen will be able to stop them.

 

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