Governor Kasich rescues Republicans with Medicaid end-run

This way the Coward Caucus won’t have to face their enraged base after actually doing their jobs and voting on something or other, so it’s a win for everyone:

Gov. John Kasich will try an end-run around the Ohio General Assembly as a whole by going directly to a legislative panel that he hopes will open the flow of $2.5 billion in federal funds over the next year and a half to pay for an expansion of Medicaid under the federal health-care law.
“The controlling board has the authority to adjust federal appropriations levels,” Mr. Moody said. “(Medicaid Director) John McCarthy has submitted a request to the controlling board that would allow a federal appropriation to a level that would allow us to receive and expend money. We believe the only remaining action is to extend coverage.”
The maneuver is likely to invite litigation by opponents of any expansion of Medicaid under the Affordable Care Act.

The seven-member panel consists of four Republican legislators, two Democrats, and one Kasich appointee. Assuming the two Democrats join Mr. Kasich’s representative, the governor would need one Republican vote to make it happen.

You may hear some punditry tales about Compassionate Conservatism, but based on what I’ve heard here this thing is pretty simple. Ohio has a lot of uninsured poor and working class people, and providers want to get paid. I agree with them! I think they should get paid, too.

I also don’t buy that this state has some deep ideological aversion to government health care, because the fact is probably 50% of the people who come through this decidedly working class law office in a rural, overwhelmingly white area are very familiar with Medicaid. Their parents are poor elderly people who rely on Medicaid or their kids are covered by Medicaid. Sometimes both things are true.

If we’re all True Conservatives who are up nights worrying over a “government take-over of health care” in this GOP-majority county I’m not seeing any evidence of that.

77 replies
  1. 1
    Richard Mayhew says:

    Good news Everybody — and with Virginia looking to elect McCauliffe (sic) and his promise to expand Medicaid, the number of hold-out states with large populations is shrinking to the usual suspects.

  2. 2
    aimai says:

    Hey Kay, very good analysis. This is indeed the Coward’s, Bedwetters, Angry People and Professional Forgetters caucus.

  3. 3
    Villago Delenda Est says:

    Good news, Kay.

    However, bigfoot is alive and well and stomping all over front pagers right now!

  4. 4
    Kay says:

    @Villago Delenda Est:

    I know. I really blew it. I stomped on two.

  5. 5
    Higgs Boson's Mate (Crystal Set) says:

    I can tell you exactly when Republicans realize that ACA is a roaring success. It will be when they introduce a bill to rename it the Ronald Reagan Health Care for America Plan.

  6. 6
    Kay says:

    @aimai:

    Kasich talks about mentally ill people in his compassionate conservative riff but it really is true. This is a small town and it’s a real problem. Cops don’t know what to do, lawyers don’t know what to do, family members are exhausted caring for the adult but they have huge (valid) issues with the loss of privacy and autonomy with a court-ordered incompetency adjudication .. it’s a mess.

    He talks about mentally ill people ending up in jail where they clearly don’t belong, but often they don’t really belong in nursing homes either. They could live more independently than that and probably cheaper, too.

  7. 7
    Higgs Boson's Mate (Crystal Set) says:

    @Kay:

    Shame! If only each new post didn’t obliterate the previous ones.

  8. 8
    Villago Delenda Est says:

    @Kay:

    This would require some people thinking long term, not short term, and that’s no longer a Rethuglican forte.

    Reagan really fucked things up opening up the gates. The old ways were not good, but Reagan’s alternative was not much better. Just moving the ignored problem from institutions to the streets.

  9. 9
    catclub says:

    @Kay: Hey, that’s my neighbor! Until she runs up against the court system – for who knows what – Nothing will be done. But everyone knows something should be done.

    She has no nearby family.

  10. 10
    Villago Delenda Est says:

    OT, but in the ‘well, duh!’ department, more from Noisemax:

    Ex-NYPD Chief: Kenya Attack Could Happen Here

    Yes, and odds are good that it will be some redneck assholes making a “point” about the Kenyan Islamoatheist.

  11. 11
    c u n d gulag says:

    “Compassionate Conservatism” means that they won’t openly laugh while making people suffer.

    Merely, smile.

    Then, smirk.

    Then, gloat.

  12. 12
    The Dangerman says:

    Jon Stewart did a funny bit last night on Medicaid Expansion; well worth going and finding.

    I’ve lost track on what the hell is happening with the Debt Ceiling; sounds like the Republicans are loading up the Senate bill with sweet sounding poison pills. Fuckers.

  13. 13
    Higgs Boson's Mate (Crystal Set) says:

    @Villago Delenda Est:

    The old ways were not good, but Reagan’s alternative was not much better. Just moving the ignored problem from institutions to the streets.

    Liberals fail to appreciate the genius of Reagan’s move. Shoving the mentally ill onto the streets enables the police to kill them without consequences.

  14. 14
    Belafon says:

    SemiOT, from Daily Kos: The health care sign up site now has a way to view the plans before you have to sign up. Go to the bottom of the diary for details.

  15. 15
    Villago Delenda Est says:

    @The Dangerman:

    Not going to help them. They still are under the impression that they’re dealing with Stepin Fetchit. They’re not. They’re dealing with a blah who can think circles around them in his sleep.

  16. 16
    Villago Delenda Est says:

    @Higgs Boson’s Mate (Crystal Set):

    Cynical take, but unfortunately, that’s precisely what has happened.

  17. 17

    Sullivan’s brief moment of lucidity turned out to be short lived. He has series of posts titled Heckuva job Kathleen. Comparing the teething problems of ACA to the rank incompetence of Micheal Brown.

  18. 18
    Mark S. says:

    I’m sure there’s a free market solution to the problem of mental illness. Maybe I’ll search the Reason archives for it.

  19. 19
    Villago Delenda Est says:

    @schrodinger’s cat:

    Stopped clock, etc.

    Tory shithaid is a Tory shithaid. In perpetuity.

  20. 20
    Kay says:

    @Belafon:

    I’m glad they’re covering it. It’s ideal for kos. They have all those readers and posters in all 50 states and they can do real-time, actual reporting. They do a great job with elections and this is a little like that. I was hoping they’d go crazy with it, because there’s a need and they’re so set up to fill it.

  21. 21
    beltane says:

    @schrodinger’s cat: Kathleen Sebelius is a woman. In Sully’s world, all women except Margaret Thatcher are assumed to be incompetent or evil in some way.

  22. 22
    Jeremy says:

    @schrodinger’s cat: LOL ! So a few computer glitches with the health care program is the same as allowing an entire city to drown.

  23. 23

    @beltane: Why the exception for Thatcher, I wonder.

  24. 24
    Turgidson says:

    Somebody is gearing up for his reelection campaign.

  25. 25
    Omnes Omnibus says:

    @schrodinger’s cat: Sullivan was born in 1963; Sullivan is a Tory. Thatcher became the leader of the Conservative Party in 1975 and then PM in 1979. She was the face of the Tories during his formative political years.

  26. 26
    WereBear says:

    @Kay: He talks about mentally ill people ending up in jail, where they clearly don’t belong, but often they don’t really belong in nursing homes either. They could live more independently than that, and probably cheaper, too.

    There is a HUGE cohort who could use a form of “assisted living.” Scores of corrections officers have confirmed that 90% of the people they are responsible for could do just fine if they only had a minimal level of support, and a few people to tell them what to do, and what not to.

  27. 27
    Kay says:

    @Turgidson:

    He is. I’m pleased that he’s so frantic. He sounds a little unhinged lately. He loves ALL of us!

    I think we have a good candidate, too. I thought we’d get a placeholder because Kasich is stronger than anticipated, but I’m hoping for a real race.

  28. 28
    Yatsuno says:

    @Turgidson: I calmly await the howls of RINO and the inevitable primary from the right. This could get fun.

  29. 29
    Ripley says:

    @schrodinger’s cat: In the words of Austin Powers, “She’s a man, baby!”

  30. 30
    beth says:

    @schrodinger’s cat: IIRC, didn’t he have to delay the launch of his website off the Daily Beast due to technical problems? I wonder who he fired over it? Luckily his saner readers are talking him down from his hysteria.

  31. 31
    Flying Squirrel Girl says:

    I’ve been shopping on the exchange for plans (I live in Texas so my elected officials are not making it easy) and here is what I have found: the rates I am shopping for a silver plan are comparable to the rates my employer was paying before I left the country 6 years ago. If I lived in a state that chose to expand Medicaid things would look even better.

    I really have no complaints about the system so far.

  32. 32
    👾 Martin says:

    @Villago Delenda Est:

    Reagan really fucked things up opening up the gates. The old ways were not good, but Reagan’s alternative was not much better. Just moving the ignored problem from institutions to the streets.

    I don’t think there was a clear solution. SCOTUS issued a series of rulings in the late 70s/early 80s that gave quite a lot of rights to individuals that had been involuntarily committed. They were needed rights, but they also created a huge burden for the industry without a lot of clarity of how to proceed. In particular:

    A finding of ‘mental illness’ alone cannot justify a State’s locking a person up against his will and keeping him indefinitely in simple custodial confinement. In short, a state cannot constitutionally confine without more a nondangerous individual who is capable of surviving safely in freedom by himself or with the help of willing and responsible family members or friends.

    So anyone who was clearly ill but not dangerous, and possibly unable to care of him/herself, couldn’t be committed. There’s no safety net for families trying to care for these individuals, and many can’t provide 24 hour supervision while still working jobs, and can’t commit these individuals. It’s inevitable that most of them become homeless until such time as they become criminals or dangerous, and then you wind up with the conflict between the law enforcement role and the need to commit. They get medicated, the risk to the public goes away, and they must then be released. Once homeless again, they can’t afford the meds, and back in they go.

    The foundations for solving this problem didn’t (and largely still don’t) exist, because what’s needed are safety nets like expanding Medicaid to that family members can get support, cost-effective care facilities for these individuals, and a shitton of things that the GOP doesn’t want to pay for. And a working wage alone would help an awful lot of that. It might take a state stepping up and providing a good model for everyone to follow.

  33. 33
    Kay says:

    @WereBear:

    We have a place, it’s subsidized housing with an attendant, and then we put in nurse visits two times a week.

    If we quadrupled the units (there are 11) we could fill them tomorrow, just from lawyer referrals.

  34. 34
    tuna says:

    It’s all about jobs. Cleveland Clinic is laying off because the pool of paying customers continues to shrink since the GOP took over. One of the top employers in Ohio is Walmart….50,000 employees unable to buy insurance.

  35. 35
    Kay says:

    @Flying Squirrel Girl:

    Thanks so much. I’m curious, and the internet has let me down on this.

    I thought there would be better state-specific coverage of what’s happening, frankly. I thought, “oh, the (liberal) internet will be perfect for this!” I am VERY disappointed in ALL of us :)

  36. 36
    Sister Rail Gun of Warm Humanitarianism says:

    @Belafon:

    The health care sign up site now has a way to view the plans before you have to sign up.

    That’s good, because I still can’t get in. Beginning to wonder if the setup failure is in querying the state’s servers for whatever they’re querying for. I can get through the sign-up process now before I get an error, and the user name is kicked out on retry as already existing.

  37. 37
    Kay says:

    @👾 Martin:

    What happens in Ohio is this: cops get called. Cops can’t take person to emergency room (which is the intake) unless they see behavior that is a danger to person or others. Cops call social worker. Cops and social worker try to persuade person to come with them to the emergency room. Person refuses. Everyone leaves. Family members, the people who called the cops, are then right back where they started.

  38. 38
    👾 Martin says:

    @Kay: It’ll come. The first few weeks will hardly be representative – lots of window shopping, not much enrolling, and many of the kinks will be ironed out. I’m sure most of the insurers are scrambling as well (the co-op executive I know is definitely scrambling).

    My guess is there will be a public information push between Nov 1 and Nov 15.

  39. 39
    debbie says:

    Kasich’s gal pal Mary Taylor must be spitting nails.

  40. 40
    Manyakitty says:

    @Kay: As much as I dislike most of Kasich’s agenda, there are a few points (like this one) where I agree with him. Glad to see he’s at least trying to circumvent the lunatic fringe.

  41. 41
    Kay says:

    @debbie:

    I know. Isn’t that delicious?

    I was reading about this, googling, and I found a Tea Party post from right after the SCOTUS decision. She and Kasich told TP they would do NOTHING to promote Obamacare. They promised. Betrayal!

  42. 42
    Kay says:

    @👾 Martin:

    I saw CA is on track as far as numbers.

    I just think it’s this really interesting huge…thing that has never happened before so I’d like to watch it, warts and all. I think a big noisy site like kos would be perfect for that sort of reporting, because they have all those diarists in the states.

  43. 43
    👾 Martin says:

    @Kay: But I think the states know that you can’t draw conclusions this early, and that it’s so politically charged that no matter what the numbers look like, it’ll be used to attack them. They’ll have to release numbers eventually but can wait until something more representative can be put out there.

  44. 44
    The Sheriff's A Ni- says:

    @Turgidson: I give Kasich credit for being smart enough to balance the Suicide Caucus’s demands with the Voinovich / Latourette moderate conservatism that kept Ohio a somewhat redder shade of purple. Its not an easy balancing act, and I’m not sure how long he can keep it up, but so far he’s been good at it.

    @Kay: That said, Fitzgerald’s a likewise bright guy who has the credit of ‘cleaning up Cuyahoga County’ for a varying definition of what a post-Dimora cleanup needed. He’s young and suburban, so he’ll likely register better with the non-rural voters than Strickland did. I’m not sure that will be enough to topple Kasich, but early returns aren’t looking too horrible.

  45. 45
    Chris says:

    @c u n d gulag:

    I remember reading that “compassionate conservatism” was a reference to some Christian, Gilded Age doctrine in which welfare was the responsibility of churches, who dispensed it along with proselytism. A dog whistle IOW. It would explain a bunch.

  46. 46
    Suffern ACE says:

    @beth:

    I wonder who he fired over it?

    Unpaid intern who was still on her parents’ insurance so she could work for him.

  47. 47
    LanceThruster says:

    “If this is going to be a Christian nation that doesn’t help the poor, either we have to pretend that Jesus was just as selfish as we are, or we’ve got to acknowledge that He commanded us to love the poor and serve the needy without condition and then admit that we just don’t want to do it.”

    ― Stephen Colbert

  48. 48
    Kay says:

    @The Sheriff’s A Ni-:

    He was here about a month ago and we were impressed. Like I said, I expected it to be a weak candidate who wants to run for “name recognition” or whatever the hell reason they run in a bad year, but I thought he came off strong. He’ll get at most 8000 votes out of this county so we were surprised he came out at all.

    About 40 came to the event which is a good turnout, especially a year out. Every single local labor leader-type person was there. I know they’re terrified of RTW, so hopefully they can get people out.

  49. 49
    burnspbesq says:

    @Higgs Boson’s Mate (Crystal Set):

    I can tell you exactly when Republicans realize that ACA is a roaring success. It will be when they introduce a bill to rename it the Ronald Reagan Health Care for America Plan.

    That moment will never come. The Republican Party will have self-destructed before then. Some member of some new center-right party may do that someday.

  50. 50

    Andrew Sullivan now has 30000 paid subscribers, who are these people?

    ETA: And he doesn’t even allow comments.

  51. 51
    johnny aquitard says:

    @Villago Delenda Est:

    Reagan’s alternative was not much better. Just moving the ignored problem from institutions to the streets.

    It’s cost shifting. Regean’s alternative was typical gooper strategy: shift the costs to where they are not readily visible but are eventually borne by the 99% and claim Free Market Republican Jesus has made us all better off.

    By tossing the mentally ill out on the street Regean shifted the costs of their care onto society in non-direct ways while claimed he was cutting costs, trimming gub’mint and making it appear as if the rising tide of tax cuts for the wealthy were lifting everyone else’s boat.

    Same as the GOP law that forced ER’s to provide care for the indigent. It sounded great, compassionate conservatism! But in reality it merely shifted the costs regressively onto the insured middle class — the wealthy can afford a doubling or even a tenfold increase of their premiums or they can self-insure.

    Paying for our own health crisis or for some debilitating mental illness like schizophrenia in a family member can easily swamp us, financially and emotionally; the 1% didn’t leave the rest of us with much freeboard on our boats.

  52. 52
    Patrick says:

    @schrodinger’s cat:

    Sullivan’s brief moment of lucidity turned out to be short lived. He has series of posts titled Heckuva job Kathleen. Comparing the teething problems of ACA to the rank incompetence of Micheal Brown.

    So Katrina is the same thing as ACA? Goodness!

    The Republican party has done whatever it could to do damage ACA. When the law was created, nobody anticipated that a whopping 26 states would not create their own exchange. This now became the job of the federal government. And this is a big part of why the roll-out has been more difficult.

    Could this Sullivan (I have no idea who he is) please tell us and give us examples on how the Democratic party did whatever it could to damage FEMA and make it harder for Michael Brown during Katrina?

    I think not. It is a DUMB comparison. But it also shows that he has (intentionally?) refused to give any blame to the GOP for their anti-American behavior.

  53. 53

    @Patrick: Sullivan is Andrew Sullivan of the Daily Dish, an MSM pundit by profession.

  54. 54
    Patrick says:

    @schrodinger’s cat:

    Thanks. MSM pundit explains it.

  55. 55
    piratedan says:

    @Patrick: well they are very similar, because like in the problem with Katrina, we only had a week’s notice that it was coming and to move the necessary resources into locations to allow them to respond quickly, and then subsequently didn’t move them or coordinate with local officials or even get them to where they were needed… just like with the ACA, where we had years to know that it was coming and then on the day that it debuts to the nation, we send everyone that knows how to support it when it goes live home because one part of the body politic decided that it would shut down the Federal Government… see the parallels are scary aren’t they? ////

  56. 56
    aimai says:

    @WereBear: There is actually a huge SRO somewhere around here, for homeless women, but one of the women who works there told us that about 60 percent of them had both/either substance abuse or mental health issues (and of course the two things go hand in hand) but that there wasn’t enough money to have someone on staff 24/7 to help them out. And this is a huge building–like 250 women–so you ‘d think it would pay back in spades to actually deliver the services that are needed right to the door of these women.

  57. 57
    nanute says:

    Now that the ACA is going into effect, watch how many more Republican dominoes fall, They rage against the federal machine, except when there’s money from blue states to be had.

  58. 58
    johnny aquitard says:

    @Villago Delenda Est: It’s what they knew would happen. But if they had fessed up about what they really wanted to accomplish and come out with a proposal to load up vans with the mentally ill and drive them around with the tail-pipe rerouted to the back, that would have let the cat out of the bag.

    But by dumping the mentally ill on the street they pretty much got the same effect, it just takes longer.

  59. 59
    Origuy says:

    OT: John Scalzi just tweeted this sighting of a pro-secession billboard. Geography Fail!

  60. 60
  61. 61
    James E Powell says:

    If we’re all True Conservatives who are up nights worrying over a “government take-over of health care” in this GOP-majority county I’m not seeing any evidence of that.

    They aren’t really worried about a government take-over of health care. They are worried that a government health care program will mean that the [insert racist epithet] will be entitled to the same benefits they get. Which they view as deeply and inherently wrong somehow.

  62. 62
    johnny aquitard says:

    @Omnes Omnibus:

    She was the face of the Tories during his formative political years.

    She became the mother he could love.

  63. 63
    beltane says:

    @Origuy: I have a hunch that “contiguous” doesn’t mean what they think it means. Or maybe they think the abbreviation for Mississippi is “MI”.

  64. 64
    👾 Martin says:

    @Origuy: I imagine the rest of the Confederacy is feeling a little left out right about now.

  65. 65
    Suffern ACE says:

    @Origuy: They will never forgive Arkansas for giving them Bill Clinton.

  66. 66
    piratedan says:

    @👾 Martin: South Carolina is going to have some hurt feefees most def

  67. 67
    Suffern ACE says:

    @Origuy: They will never forgive Arkansas for giving them Bill Clinton.

  68. 68
    scav says:

    @Origuy: Words. Sooooo tricky what with their Gotcha! elitist definitions ‘n’ all. Maps are almost as bad.

  69. 69
    Patrick says:

    @piratedan:

    So you knew 3 years ago that 26 states were not going to have their state exchange and thus leaving for the Feds to pickup. You must be a psychic…

    BTW – The approved allocation of funds for this assumed that just about every state would create their own exchange. they didn’t and thus the feds had to scramble for new funding.

  70. 70
    piratedan says:

    @Patrick: you must have missed my snark tag at the end of my post…. I’ll chalk that up to a pre-existing condition :-)

  71. 71
    Patrick says:

    @piratedan:

    Sorry!!!

    I’m still angry from debating an idiot tea bagger this morning.

  72. 72
    piratedan says:

    @Patrick: it’s cool, I didn’t take offense and to claim that I haven’t made the same gaffe, well that would be just a tad inaccurate as well. Snark meters need adjustment and calibration from time to time.

  73. 73
    scav says:

    @beltane: No Way could Mississippi be a liberated ambiguously-married female. The USPS and Entire Federal Government is dissing us!!!

  74. 74
    👾 Martin says:

    US President @BarackObama appreciates Republican proposal over debt crisis but has some concerns

    Translated: No. And my compromise is I won’t twist the knife on you guys.

  75. 75
    Elizabelle says:

    @nanute:

    Now that the ACA is going into effect, watch how many more Republican dominoes fall

    Oh, I hope so.

  76. 76
    rikyrah says:

    Kay

    I knew you’d keep on top of this. So Kasich’s trying to get re-elected..uh huh

  77. 77

    @Origuy:

    Apparently the billboard has been corrected, though no one seems to know why Arkansas was left out.  I guess it’s not a right-wing movement unless you can purposely snub somebody. Either that, or Arkansas is too liberal for them, frightening as that might be.

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