Funding Medicaid expansion is more likely to be approved in Ohio after the state's House speaker replaced two Republican members of a legislative panel on Monday.
House Speaker William Batchelder has asked GOP Reps. Ross McGregor, of Springfield, and Jeff McClain, of Upper Sandusky, to serve on the state's Controlling Board, said Mike Dittoe, Batchelder's spokesman.
The powerful but little-known board was questioning a request from Republican Gov. John Kasich Monday afternoon to allow federal money to be spent on expanding the Medicaid health program to give coverage to thousands more residents. People lined the hearing room to await the decision and more people sat in the Statehouse atrium to hear the vote.
Ohio recently got federal approval to extend Medicaid eligibility, but Kasich's administration needs legislative approval to spend federal money on the estimated 366,000 newly eligible residents.
McGregor said before the hearing that he supports an expansion of the program — a key component of President Barack Obama's federal health care law — for the poor and disabled.
"I wish that we would have been able to get to this point via a legislative route, but that does not appear to be viable at this time," McGregor said in a telephone interview. "And I think that it's important that we be in a position as a state to receive the full benefits of expansion that begin in January."
The federal government would pay the entire cost of the expansion for the first three years, gradually phasing down to 90 percent — still well above Ohio's current level of 64 percent.
Medicaid already provides coverage to one of every five residents in Ohio. Ohio would get $13 billion from the federal government to cover costs of an expanded program over the next seven years, according to the Kasich administration.
Medicaid expansion allows those making up to 138 percent of the federal poverty level, or about $15,860 for an individual, to be eligible for the program. Many are childless adults living in poverty.
Kasich has pushed for Medicaid expansion since he pitched his version of the state's two-year budget in February. But the GOP-controlled Legislature balked at the idea and has tried to find common ground on other changes to the Medicaid program.
The Kasich administration is asking the Controlling Board on Monday for the authority to spend $561.7 million in federal money this budget year and almost $2 billion next year to cover the new Medicaid population.
The seven-member board handles certain adjustments to the state budget. It's made up of an administration official and six lawmakers — two Democrats and four Republicans.
The Democrats and Kasich appointee are expected to favor the request. McGregor, who is finishing his last term in the House, appears to be the single Republican vote that Kasich has been searching for.
Asked whether he would vote "yes," McGregor said he plans on being consistent with his support of Medicaid, barring any arguments that change his mind.
McClain said Monday in an interview that he would vote "no" on the request if he has a chance.
Many Republicans in Ohio are averse to the new health law and resistant to expanding government programs. They have cited concerns about increasing the national debt and fears that the money from Washington could be cut off.
Board approval of expansion is likely to spark a lawsuit.
State Rep. Ron Young, one of more than 30 House Republicans who formally protested the Controlling Board request last week, said he expects to be among plaintiffs in a lawsuit being prepared by expansion opponents.
Maurice Thompson, executive director of the 1851 Center for Constitutional Law, said the group would argue in the suit that the board is violating the Legislature's intent not to expand Medicaid.
The Kasich administration has said the state would be ready to implement an expansion of the program when it gets legislative backing. Newly eligible residents could start enrolling as soon as this month for coverage that takes effect in January.