Count Ohio’s governor and former presidential candidate John Kasich as one Republican who is not chomping at the bit to repeal Obamacare.
Kasich is "very concerned" about GOP plans to unravel the law's Medicaid expansion, said Ohio Democratic Sen. Sherrod Brown, who met with Kasich last month. Kasich himself voiced that sentiment in a brief exchange with Ohio reporters on Wednesday.
“Let’s just say they got rid of it, didn’t replace it with anything,” Kasich said of GOP plans to kill the Affordable Care Act, also known as Obamacare. “What happens to drug treatment? What happens to mental health counseling? What happens to these people who have very high cholesterol and are victims of heart attacks, what happens to them?”
About 700,000 Ohioans gained coverage through Obamacare's expansion of Medicaid, the state-federal health program for the poor. During his presidential bid, Kasich staunchly defended the expansion, saying it was rooted in his Christian faith and brought Ohio’s most vulnerable population out of the shadows.
Now, the fate of Medicaid expansion will be a major flashpoint as Congress opens debate on dismantling the health care law and putting in place a GOP alternative. Ohio was one of 32 states that took advantage of the expansion, which now covers 11 million Americans.
Kasich, as a high-profile Republican governor and possible 2020 presidential contender, could play a major role in the debate — either as a flame-throwing critic of his own party’s attitudes toward the poor, or as an instrumental voice in shaping the Republicans’ final health reform proposal. In a savvy PR move, Kasich's administration released a report last week showing how Medicaid expansion has helped improve the health and financial well-being of thousands of Ohio residents.
“Governors, especially Republican governors, are likely to play a very important role in not only what the replacement plan looks like but the Medicaid debate more broadly,” said Judy Solomon, vice president for health policy at the Center on Budget and Policy Priorities, a liberal think tank in Washington.
In the coming weeks, the GOP-controlled House and Senate are expected to approve a budget agreement that will allow lawmakers to repeal key pieces of the Affordable Care Act, including the Medicaid expansion, on a fast-track basis. To prevent a lapse in coverage, Republicans plan to delay the effective date of that repeal until they come up with a replacement plan.
“During that time period, the expansion under Medicaid will be fully funded,” said Sen. Rob Portman, R-Ohio. He said Republicans will make sure they’re not “pulling the rug out from under people.”
But it’s far from clear what the GOP alternative will look like. And some Democrats question whether the Republicans will even come up with a replacement.
Kasich seems to share at least some of that anxiety.
“There’s room for improvement (of Obamacare), but to repeal and not to replace?” he said Wednesday. “I just want to know what’s going to happen to all those people who find themselves out in the cold.”
Republicans say they want to give states more flexibility to run Medicaid, allowing them to innovate and tailor programs that suit their particular population
A spokeswoman for Kasich’s Office of Health Transformation declined to say what Kasich wants to see Congress do on the Medicaid front. She noted that GOP leaders have asked Kasich and other governors for input on their replacement plan.
“We are in the process of developing our formal response to them,” said Connie Luck, the spokeswoman. “Until we respond, however, commenting publicly would be premature.”
Contributing: Cincinnati Enquirer reporter Jessie Balmert.