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Although his recent presidential campaign has placed Ohio Gov. John Kasich in the national spotlight, one Ohio University professor is more enthralled by the governor’s unique Medicaid decisions central to the Buckeye State.
Daniel Skinner, an assistant professor of health policy at OU’s Heritage College of Osteopathic Medicine at Dublin, contributed an article to the bi-monthly, nationalJournal of Health Politics, Policy and Law that chronicles Kasich’s embracement of Medicaid expansion in 2012 and his subsequent reform of it during its reauthorization this past year.
The piece is part of a series the publication runs called Reports from the States.
Colleen Grogan, a professor at the University of Chicago and editor of the journal, said the journal is not only focused on health policy but also investigating the subject’s history and background which shaped its current form.
“There are big political issues on the table and states are deciding on how to best (adapt) to them,” Grogan said.
Skinner said he wrote the piece to “tell the tale of Medicaid expansion in Ohio” and give national readers a perspective on the inner workings of the state.
He argues in the essay that Kasich finds himself in a limited cadre of Republican governors — along with Gov. Rick Snyder of Michigan and, to a lesser extent, Gov. Mike Pence of Indiana — who expanded Medicaid in their states despite their party’s opposition to the Affordable Care Act, otherwise known as “ObamaCare.”
Despite Kasich’s acceptance of federally granted monies through the Controlling Board, a committee outside of the legislature that could allocate funds, the Ohio governor would later reform the Medicaid expansion he originally initiated, placing him in an uncommon position that blurs party lines.
And, because Ohio functions as a swing state and the political atmosphere isn’t heavily skewed to one party, Kasich had more political freedom in his stances than governors in states that more closely adhere to party lines, Skinner’s essay maintained.
“What I think makes Kasich a very interesting figure is that he appears to have carved out a space for him to say ‘Look, I’m willing to take on my own party and do what I think is right,’” Skinner said, “as well as having many positions that his party generally finds acceptable.”
He said the expansion of Medicaid helped to insure 100 percent of residents below the federal poverty level along with 38 percent of residents that land just above it. Prior to the expansion, only the bottom 90 percent of individuals below the federal poverty level could qualify.
“When you start adjusting those numbers, what you’re doing is moving people on and off Medicaid and access to healthcare,” Skinner said. “Over 50 percent of kids born in Ohio are born on Medicaid. So, it plays a hugely important role in child health.”
Since it is typically thought as a governor’s job to bring in as much money to the state as possible, Kasich finds himself in a situation that a senator or congressman would not face, Skinner said.
“You have to have a good reason to not take federal money,” Grogan said. “So Republican governors have found themselves in a quandary.”
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Grogan also said the ongoing state implementations of the Affordable Care Act, which includes Medicaid, is a subject often covered by the journal.
Skinner also has a political and rhetorical background and has written about subjects such as reproductive health.
“I am extremely proud of the work being done by our Dublin faculty,” Dr. William Burke, dean of HCOM’s Dublin campus, said.