Ohio Obamacare expansion 33 percent over budget in first year

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Enrollment in Ohio???s expanded Medicaid program was 485,462 in December, 33 percent higher than expected.

Gov. John Kasich???s Obamacare expansion took effect in January 2014, and it has been over budget ever since. Enrollment was at 492,121 last month, 34 percent higher than the Republican governor???s initial projection for this coming July.

The Ohio Department of Medicaid never released a December caseload study, but a December eligibility and expenditures report pegged enrollment at 471,452. Caseload reports, which include revisions for previous months, have consistently shown large increases in previous months??? enrollment due to backdated eligibility.

For example, June enrollment in Kasich???s Obamacare expansion was initially reported as 285,553 before increasing in every subsequent caseload report. June enrollment was revised to 367,446 in ODM???s January caseload release.

???Though it won???t save Ohio taxpayers from paying the growing check he has written, it would be nice if John Kasich admitted he was wrong on enrollment numbers and show an ounce of remorse for being so wrong,??? Matt Mayer, president of free-market think tank Opportunity Ohio, said in an email to Ohio Watchdog.

???The same goes for the editorial boards who continue to shill for Medicaid expansion in spite of the cold, hard facts of what it is going to cost us,??? Mayer added.

$300 million per month

July enrollment, first reported as 338,707, has been revised upward every month and was reported as 394,162 in the January caseload release. November enrollment jumped from 450,941 in the November report to 469,737 in January.

Ohio spent more than $2.1 billion in Obamacare money to pay for Medicaid expansion benefits through December. A $2.56 billion Ohio Controlling Board appropriation for the expansion was meant to last until July.

With monthly expenditures topping $300 million by the end of 2014, ODM will almost certainly exhaust its Controlling Board appropriation this month. The Kasich administration has not responded to Ohio Watchdog inquiries about its plans to pay for expansion through June.

Republican leaders in the Ohio House and Ohio Senate have signaled they would make no effort to overturn Kasich???s unilateral expansion of Medicaid to able-bodied, working-age adults with no dependent children.

Medicaid Premiums Coming?

After putting half a million Ohioans on Medicaid under Obamacare, Kasich is emphasizing ???welfare to work??? proposals in his budget for fiscal 2016 and fiscal 2017.

In a House Finance and Appropriations Committee hearing Wednesday, Democrats expressed skepticism over Kasich???s recommendation that adults on Medicaid pay small premiums if their income exceeds 100 percent of the federal poverty line.

???My concern is it will turn less into a personal responsibility issue as more of an unnecessary burden, an unnecessary obligation,??? Rep. Dan Ramos said.

Complaining that some Ohioans would forgo Medicaid coverage if required to pay a premium, Ramos asked, ???Where???s the idea that this is a responsibility issue for these folks who have responsibilities, who have bills, who have a job????

The Kasich administration has estimated ???about half??? of the Ohioans added to Medicaid under Obamacare have jobs.

Greg Moody, director of Kasich???s Office of Health Transformation, reminded Ramos eligibility for Obamacare exchange subsidies begins at 100 percent of the federal poverty line.

???Without expansion, federal law requires individuals to have insurance for which they pay a premium on a monthly basis that, at low-income ranges around 100 percent, are about $20 a month,??? Moody said.

???It seems fair to reflect that policy so as to not create a distinction between people at exactly the same income level when they make a choice to get coverage through the exchange versus coverage through Medicaid,??? he added.

Kasich ??? who claims his Obamacare expansion has nothing to do with Obamacare ??? could address this issue by capping eligibility for Medicaid at 100 percent of poverty, but that would mean missing out on billions in new federal spending.

Kasich Defends Expansion

While traveling the country promoting a federal balanced budget amendment, Kasich has vociferously defended his decision to add almost 500,000 people to a federally funded entitlement program. Kasich has even accused Republicans in states not embracing Obamacare of ignoring God???s will.

The Columbus Dispatch, Cleveland Plain Dealer, Cincinnati Enquirer, Toledo Blade and Akron Beacon-Journal endorsed Obamacare???s Medicaid expansion almost immediately after Kasich introduced it in his 2013 budget plan.

The state???s largest newspapers have all reported the Kasich administration???s Obamacare projections without skepticism while ignoring critics??? concerns about Medicaid expansion???s likely cost and outcomes.

Jason Hart ( writes for, where an earlier version of this story previously appeared. Reprinted with permission.