As many anticipated, Governor Kasich and his administration are exploring expanding Medicaid coverage to low-income working Ohioans without legislative approval.  On Friday, October 11, 2013, the official agenda for the upcoming October 21 meeting of the Controlling Board included an appropriation request for the state Medicaid budget - an astonishing $561.7 million in Fiscal Year 2014 and more than $1.99 billion in FY 2015.  To be successful, this alternative pathway would require the Governor to issue an Executive Order approving the expansion and for the Controlling Board to approve the requested funds.  However, it would only be a temporary expansion unless the full General Assembly acts; Executive Orders terminate at the end of a governor’s current term in office.

Should the Controlling Board approve the request, Ohio would be in line to receive the expanded federal funding that is available to states willing to expand coverage.  States need to have their programs in place by January 1, 2014, to receive the full benefit of the expanded federal funding.  The Kasich administration also announced it had received approval of the State Medicaid Plan Amendment authorizing the expansion of the program here in Ohio from the federal Centers for Medicare and Medicaid Services (CMS), another key step in being ready to implement the expansion on time.

While the administration may be ready to act, the Controlling Board will likely give the request significant scrutiny.  The Controlling Board, which must approve increased funding requests, consists of seven members: three legislators from each house (four Republicans and two Democrats in the 130th General Assembly) and a representative of the Office of Budget and Management.  The General Assembly already denied the same request to expand Medicaid during this year’s budget debate.  And with Medicaid reform bills pending in both chambers - notably House Bill 176 (Sears) and Senate Bill 206 (Burke) - observers expect an intense hearing on the issue.