This article originally appeared on watchdog.org.
Ohioâ??s Obamacare Medicaid expansion will continue until at least July, despite burning through $2.56 billion in federal funding four months early.
Unless enrollment drops abruptly, Medicaid expansion will be more thanÂ $1 billion over budget by the end of Ohioâ??s currentÂ fiscal year June 30. TheÂ expansionâ??s 492,121Â January enrollmentÂ was 34 percent higher than stateÂ projections for July.
Even with the federal government reimbursingÂ Ohio for allÂ of the programâ??sÂ benefit costs, how can the Ohio Department of Medicaid continue the Obamacare expansion without legislative approval?
ODM does notÂ need a new Obamacare expansion appropriationÂ because the agencyÂ â??has broad authority under Ohio law to operate the Medicaid program,â?ť Joint Medicaid Oversight Committee directorÂ Susan Ackerman toldÂ Ohio Watchdog via email.
â??Appropriations for the Medicaid budget are set at the line item level and not by category of service or population,â?ť Ackerman said. â??Department of Medicaid may pay for Medicaid services from any of their Medicaid service-related line items up to the appropriation set by the General Assembly.â?ť
In other words,Â as long as ODMâ??sÂ total expenditures fallÂ within limitsÂ set by state lawmakers,Â spending approvedÂ for traditional Medicaid recipients â?? children, pregnant women, the physically disabled, the elderly and families below the federal poverty line â?? can be used for the Obamacare expansion instead.
ODMâ??s enrollment projections have beenÂ wildly inaccurate, withÂ high Obamacare expansion enrollment offset by low enrollment from those previously eligible.InÂ January, Ohio had 125,457 more Obamacare expansion enrollees and 149,656 fewer traditional Medicaid enrollees than expected.
By using appropriations meant for traditional Medicaid recipients for the Obamacare expansion, Republican Gov. John Kasichâ??s administration can avoid an emergency request forÂ more money to cover the expansion Kasich implemented unilaterally.
BecauseÂ the federal governmentÂ pays for 100 percent ofÂ Obamacare expansion benefits and only 62 percent of Ohioâ??s traditional Medicaid benefits, ODM still expects to have state money leftÂ in its total budget June 30.
State taxpayers will eventually be stuck with a huge bill if the Obamacare expansion continues, but short-term federal fundingÂ makes the expansionÂ â??freeâ?ťÂ for states until 2017.
The left-leaning Urban Institute projected in 2012 thatÂ expanding MedicaidÂ would cost OhioÂ taxpayers $4Â billion through 2022.Â Kasich insists all of the expansionâ??s costs areÂ paid for with â??OhioÂ money,â?ť which is demonstrably false.
AfterÂ addingÂ working-age, able-bodied childless adults to Ohioâ??s Medicaid program in 2013, the Kasich administrationÂ turned to the Ohio Controlling BoardÂ for permission to spend $2.56 billion in Obamacare moneyÂ between Jan. 1, 2014 and June 30, 2015.
Kasich touts the programâ??s skyrocketingÂ enrollment as great news for the state, and heÂ built his budget for fiscal years 2016 and 2017 onÂ the assumption Medicaid expansion will continue.
â??Gov. Kasichâ??s unilateral expansion of ObamaCare is set to run more than a billion dollars over budget in just the first 18 months,â?ť Jonathan Ingram, research director for the free-market Foundation for Government Accountability, said in an email to Ohio Watchdog.
â??More able-bodied adults have been put on Medicaid welfare than the Kasich administration thought wouldÂ everÂ enroll. Barely a year in, Ohioâ??s Medicaid expansion costs are already spiraling out of control,â?ť Ingram continued.
â??What happens when the state has to start paying its share of Medicaid expansion costs? Gov. Kasich has already pushed nearly 500,000 able-bodied adults to the front of the line, while nearly 40,000 children and adults with developmental disabilities languish on waiting lists for services,â?ť Ingram said.
â??Heâ??s proposed funding cuts to pediatric hospitals and is now pushing to kick pregnant women off the program,â?ť Ingram added, concluding, â??With these kinds of cost overruns, who else will Kasich put on the chopping block when the ObamaCare expansion bill comes due?â?ť
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