In the course of his ongoing crusade for Medicaid expansion, Ohio governor John Kasich has suggested that Ronald Reagan, Saint Peter, and God Himself all would support his plan to accept Obamacare’s Medicaid expansion.
While we do not have special insight into the mind of the Almighty or His divine agents, we do know something about Ronald Reagan. Expanding a failing, big-government program that reduces flexibility for the states and traps generations of Americans in dependency is not consistent with the kind of conservative solutions that Reagan sought during his terms as governor of California and president of the United States.
Governor Kasich bases his argument that he is doing what Reagan would have done on the fact that Reagan expanded Medicaid when he was president. Rather than furthering Kasich’s case, however, Reagan’s actions shed light on precisely why it is that the Obama plan embraced by Kasich is so antithetical to the policies that Reagan promoted.
Kasich first points out that in 1986, Reagan signed a bill that gave states the option of participating in a program to add poor children and pregnant women to Medicaid. Aside from offering a genuine choice to the states (as opposed to the economic coercion of Obamacare), this expansion had a factor missing from the current debate: abortion.
In an era when there were perpetual fights over using public funds for abortion, the expansion assured that pregnant women would not be financially worse off carrying their children to term than they would be if they chose to have an abortion. And the policy worked. A study from the pro-abortion Guttmacher Institute found that abortions decreased and births increased following the expanded coverage in sampled states.
By contrast, Obamacare’s Medicaid expansion does nothing to help pregnant women and children. Indeed, as Ohio argued in court, Obamacare’s Medicaid expansion “transformed” the basic nature of the Medicaid program from one that gave states flexibility and applied coverage to the categorically vulnerable like pregnant women and children into a general entitlement based solely on income.
Given this shift, and the poor performance of the Medicaid program in general, it is not surprising that multiple prominent pro-life leaders in Ohio oppose Kasich’s plan for Medicaid expansion.
Kasich then points to the fact that Reagan permitted children who were restricted to receiving Medicaid-funded care in hospitals to be eligible for that care at home as well. It is a stretch to characterize this as a program “expansion” — it was more of a correction.