Will John Kasich veto Ohio GOP plan to hamstring Medicaid expansion?

COLUMBUS, Ohio — Ohio's GOP lawmakers have thrown down a challenge for Gov. John Kasich, who now must decide whether to veto their freeze of his Medicaid expansion — a freeze that could essentially kill the program for many lower-income adults.

On Tuesday morning, Kasich was in Washington, touting the benefits of Medicaid expansion in improving access to health care. Meanwhile, his fellow Republicans were working to undo the program at home. 

Republican lawmakers want to prevent new, lower-income Ohio adults from enrolling in Medicaid starting July 1, 2018. At that point, anyone who drops off the rolls, perhaps because they received higher wages during a given month, would not be able to re-enroll. Many Medicaid members drop off and re-enroll each year, so the ban would end the health care program for those people.    

Medicaid expansion has been Kasich's main answer to drug treatment as the state grapples with a heroin and opioid overdose epidemic. Ohio leads the nation in the number of overdose deaths. 

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GOP lawmakers' original proposal, originating in the Ohio Senate, had threatened the drug treatment many Medicaid members receive. About $650 million of the $940 million spent annually combating addiction in Ohio comes from Medicaid, with $280 million of that from the expansion under Obamacare. 

On Tuesday, lawmakers added an exception for those with a drug addiction or mental illness. They could enroll in Medicaid even after July 1, 2018.

Still, Kasich's fellow Ohio Republicans want to find some way to restrict Medicaid expansion. They worry about the growing costs of the program and its hazy future in Washington. On Tuesday, GOP members of Congress delayed a vote on their Obamacare replacement, uncertain if they had the votes.

And some Ohio lawmakers are still upset that Kasich went around them to expand Medicaid in 2013. 

Ohio House Republicans initially proposed regulating Medicaid expansion more carefully rather than killing it outright. But the chamber's more conservative members supported halting new Medicaid expansion enrollees, siding with their Senate colleagues. That approach prevailed in the final budget released Tuesday.

Ohio's GOP-dominated Legislature is expected to vote on the final version of the two-year budget Wednesday, sending it to Kasich. The governor has until Saturday to line-item veto any proposals he doesn't like before signing the bill into law.

Democrats have asked Kasich to veto the restrictions on Medicaid. If he does not, the GOP's changes to Medicaid would require approval from President Trump's administration. 

Follow Jessie Balmert on Twitter: @jbalmert