A state funding allotment crucial to doctors, hospitals and other Ohio Medicaid providers cleared a powerful legislative panel Monday given extraordinary authority over the government health program.
Medicaid Director Barbara Sears told the state Controlling Board ahead of its unanimous vote that failing to authorize Ohio's $264 million share of program spending risked "devastating" consequences for program providers and the 3 million Ohioans that Medicaid serves.
Another $638 million in federal matching dollars hinged on Monday's approval by the panel, whose say-so was required under a change placed into the state budget bill passed earlier this year.
Republican Gov. John Kasich's administration said that without funding approval, it would have had to cut provider payments 16 percent beginning in January to keep the state budget in balance, affecting areas including home health, behavioral health, hospitals, doctors and others.
Sears said more likely, Ohio would have simply continued spending until the program ran out of money, around May 2018.
The added approval layer was the latest in a string of hurdles the GOP-controlled Legislature has imposed — or tried to impose — on the Medicaid program under Kasich. The governor, a 2016 presidential contender, broke early with some other Republicans to accept and champion Medicaid expansion made available under the federal Affordable Care Act. The Ohio expansion now covers 700,000 low-income adults.
Kasich used the Controlling Board four years ago to make an end-run around the Legislature to get the expansion approved. That history adds a touch of irony to the new power the board was given over Medicaid in the state's latest budget.
Kasich vetoed another budget provision that had again targeted expansion, however.
State Rep. Al Landis, a Dover Republican, said Monday that he saw the new arrangement as "a problem-solving exercise" with the administration.
Cincinnati-area Republican state Sen. Bill Coley said he would have preferred to wait to approve the agency's budget until other cost-saving measures are finalized because he has feared for years that the program will "collapse under its own weight." But he said Monday he has decided to trust the administration.
State. Rep. Jack Cera, a Bellaire Democrat, questioned why the Legislature would even involve the Controlling Board in the process.
"What I'm concerned about is having a process that adds more uncertainty to a system that is sometimes on pins and needles lately," he said.
State Budget Director Tim Keen responded, "The administration, from the governor on down, is prepared to talk about the Medicaid program, how it operates, who it serves, what the benefits it provides to not only to those it serves but to the state as a whole, really at any place at any time in any forum."
Another $311 million in state spending must be authorized for 2019 to qualify for $750 million in federal funds, rounding out the Medicaid agency's $2 billion two-year budget.
Medicaid sets plan rates in November for the six months beginning Jan. 1.