State Controlling Board Votes to Sustain Medicaid Expansion
Earlier this week, the State Controlling Board approved the release of $264 million in state funding for the Ohio Department of Medicaid (ODM). These funds represent the state share of funding for coverage of the Expansion population for State Fiscal Years 2018 and 2019. Monday’s unanimous vote by Controlling Board will allow ODM to draw down an additional $638 million in federal matching funds. The requirement that ODM seek Controlling Board approval for Medicaid Expansion funding was included in House Bill 49, the State Operating Budget for FY18/19; HB 49 was signed by Governor Kasich on June 30th.
The State Controlling Board is a spending oversight panel comprised of legislators and chaired by an appointee of the Governor. The board approves contracts, authorizes appropriation increases, and in limited cases approves the release of funds for certain purposes. Controlling Board was the same entity that Kasich used to expand Medicaid coverage in 2014. The Board approved a major appropriation increase for ODM following expansion of the Medicaid program through authority granted to the Ohio Medicaid Director. In addition to requiring Controlling Board approval for Expansion, HB 49 also included language prohibiting ODM from expanding coverage in the future without legislative approval.
This vote does not mean Medicaid Expansion is safe in Ohio. The Ohio House of Representatives could still vote to override Governor Kasich’s veto of language in HB 49 freezing Expansion enrollment in FY19; the Ohio Senate would have to follow suit. Additionally, any changes to Medicaid at the federal level, including a repeal of the Affordable Care Act, would put Expansion at risk. Finally, Medicaid Expansion has become a target for at least two Republican candidates for Governor, meaning it could be put on the chopping block in 2019 after Kasich’s successor takes office.
Voters to Decide Fate of Issue 2 (Drug Price Relief Act)
On Tuesday, voters will be asked to wade into the debate of drug prices through Issue 2, a proposed statute that would tie drug prices paid by state and local entities to the price paid by the U.S. Department of Veterans Affairs. The proposal is backed by the AIDS Healthcare Foundation, who unsuccessfully pursued a similar measure in California last year. While proponents claim Issue 2 would save taxpayers $400 million, the State Office of Budget and Management as well as other independent studies have argued those savings are hard to predict and unlikely to materialize. Issue 2 is opposed by a large coalition of business and healthcare provider organizations, hospitals, and charities. Most of the funding to defeat Issue 2 has come from PhRMA.