Ohio governor John Kasich, the most vocal Republican critic of Obamacare-repeal efforts this year, is pleading with Congress to pass the health-care bill proposed by Senator Lamar Alexander (R., Tenn.) and Senator Patty Murray (D., Wash.).
The Alexander–Murray bill follows a template that Kasich and Colorado governor John Hickenlooper, a Democrat, began promoting in August: Obamacare’s mandates, regulations, and Medicaid expansion would all remain in place, and Congress would authorize spending to “stabilize” the exchanges.
In particular, Alexander–Murray would reimburse insurers for “cost-sharing reductions” Obamacare requires them to provide to certain low-income enrollees. Congress has thus far refused to appropriate money for these payments; President Obama paid the subsidies illegally anyway, but President Trump recently halted them.
“This should be a no-brainer. Get Alexander-Murray passed & signed,” Kasich wrote in a Twitter update Monday after Trump endorsed — and then unendorsed — the bill. “Then we take on the big reforms necessary to get American families the coverage they need.”
Kasich’s ideas for reform amount to managing an increasingly vast federal health-care bureaucracy more efficiently. While conservative Republicans have prodded Senate moderates to enact modest free-market reforms, Kasich has attacked all of their proposals from the left.
When Alexander–Murray was introduced, Kasich’s band of ten pro-Obamacare governors — only two of whom, including Kasich, are Republicans — fired off a letter to House and Senate leaders imploring them to “quickly pass legislation to stabilize our private health insurance markets and make quality health insurance more available and affordable.”
Kasich latched on to the Congressional Budget Office’s estimate that Alexander–Murray would reduce federal deficits by $3.8 billion over ten years, posting a video statement on Twitter the day CBO’s report was released.
“The Congressional Budget Office says that we can actually reduce the deficit modestly but also not have anybody removed from health care under Alexander-Murray. It is a great thing to be for: stabilize our market, save peoples’ health care, and move on to controlling health-care costs,” Kasich said.
“With the positive CBO score in hand, passage of Alexander-Murray is a must,” he wrote in the accompanying tweet.
But past Obamacare-related cost estimates have proven remarkably unreliable. Kasich projected that expanding Medicaid would cost $13 billion by 2020, but it has already cost taxpayers more than $15 billion. Other states have seen similarly unsustainable welfare-spending increases since expanding Medicaid, and the CBO sharply underestimated Medicaid-expansion costs, too.
Kasich was less concerned about deficit spending when he was pushing the Ohio General Assembly to expand Medicaid.
“There really is not a legitimate argument against it,” he told newspaper reporters in 2013. “What it is, is, ‘Well, you know, we’re ringing up the federal debt’ – I mean, what? You think by turning this down you’re gonna solve the federal debt?”
And listening to Kasich lobby for greater Obamacare funding now, it would be easy to forget that last year he was promising to repeal and replace Obamacare if elected president. The year before that, Kasich scoffed at CNN host Jake Tapper when Tapper questioned his embrace of Obamacare’s Medicaid expansion.
“I don’t support Obamacare; I want to repeal it, but I did expand Medicaid because I was able to bring Ohio money back home to treat the mentally ill, the drug-addicted, and to help the working poor get health care,” Kasich insisted in that May 2015 interview.
Perhaps Kasich can run for president in 2020 as the pragmatic central planner who can make Obamacare work as intended.
When Kasich decided to implement Obamacare’s expansion of Medicaid to working-age adults with no kids and no disabilities, it was not to “bring Ohio money back home,” but rather to accept a blank check for new federal deficit spending. “If a state doesn’t implement the ACA Medicaid expansion, the federal funds that would have been used for that state’s expansion are not being sent to another state,” the Congressional Research Service clarified in a 2015 memo.
In a New York Times op-ed this July, Kasich acknowledged that states “cannot expect the federal government to continue paying 90 percent of Medicaid expansion costs given our nation’s historic debt,” but since then he has continued working tirelessly to delay changes to the Medicaid expansion until after he hits his term limit in January 2019.
Kasich tried for several years to argue that Medicaid expansion was not really part of Obamacare, even though most of the Obamacare spending increases and coverage gains in Ohio and nationwide result from the law’s Medicaid expansion. With Republicans in Congress seemingly unable to deliver on years of repeal promises, Kasich is leaning into the role of pro-Obamacare Republican.
If Barack Obama’s biggest domestic-policy achievement remains in place, perhaps Kasich can run for president in 2020 as the pragmatic central planner who can make Obamacare’s mandates, subsidies, penalties, and regulations work together as intended.