Affordable Care Act: Ohio Expands Medicaid

Reviewed by Lisa Zamosky on October 24, 2013
From the WebMD Archives

Oct. 24, 2013 -- Ohio became the 25th state to expand Medicaid coverage after an extended fight between Republican Gov. John Kasich and the Republican-dominated legislature.

The state will now receive funds from the federal government to cover an estimated 275,000 more people who are too poor to buy health insurance in the new health insurance Marketplaces.

Kasich tried hard to bring his Republican colleagues on board for Medicaid expansion. But he bypassed the Ohio General Assembly, going to the state’s bipartisan Controlling Board instead for approval. The board, which is charged with providing legislative oversight over certain capital and operating expenses, voted 5-2 to accept $2.55 billion from the feds to expand the Medicaid program through July 2015.

That sparked a lawsuit filed Tuesday by a handful of Republican House members through the 1851 Center for Constitutional Law, a conservative think tank, and two right-to-life groups. They want the Ohio Supreme Court to reverse the vote because it was done without a vote of the legislature.


“In a nutshell, this is no longer about Medicaid expansion; this is about the constitutional principles of separation of powers and who should be making this policy decision for the State of Ohio. In my opinion, it should be the legislature, not an administrative board masquerading as a legislative body and on its own making a decision,” says state Rep. Matt Lynch (R), one of the plaintiffs.

Kasich did not comment on the lawsuit, but in an earlier statement said, “I look forward to continuing our partnership with the General Assembly to build upon the progress we’ve already made to make Medicaid work better for Ohioans.”

As part of the Affordable Care Act, states can elect to receive federal money to expand Medicaid, the health program for low-income adults. The federal government will cover 100% of additional costs for the first 3 years of the program, after which states will pay 10% of the costs. Twenty-four other states have expanded their Medicaid programs. Several others have proposed hybrid programs that are pending federal approval.


Lynch said even though only six state legislators joined the lawsuit, 39 Republican House members went on record protesting Kasich’s request that the Controlling Board make the decision.

Their statement, issued during a legislative session Oct. 16, reads, in part: “Our protest is not about the merits or lack of merit in expanding Medicaid. Our protest goes to the fundamental form of government upon which our country was founded -- a Republic of checks and balances and separation of powers.”

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Office of Gov. John Kasich. “Controlling Board: About."

Ohio Rep. Matt Lynch (R).

Ohio House of Representatives Journal, Oct. 16, 2013.

Ohio Rep. Louis W. Blessing III (R).

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