Portman pushing gradual Medicaid expansion cut instead of elimination

With Senate Republicans struggling to produce a health-care bill, Sen. Rob Portman of Ohio is pushing to gradually reduce federal dollars to finance an expansion of health coverage for low-income people as opposed to a House health care bill which eliminates all money by 2020.

Although Senate Republicans have yet to agree on Portman’s compromise plan, it would provide Ohio and other states with seven additional years of federal money to help pay part of the costs of expanding coverage of Medicaid, a joint federal and state program which pays health costs for low-income people.

The Medicaid expansion was a major feature of the 2010 health law known as Obamacare and allowed Gov. John Kasich to use federal money to provide coverage to nearly 700,000 low-income people in the state.

Obamacare allowed states to provide Medicaid coverage to families of four earning as much as $33,948 a year, which is 138 percent above the federal poverty line.

“My goal is to ensure that those on expanded Medicaid continue to have good health care options under a new system, whether it’s under the current Medicaid structure or affordable health care options on the private market,” Portman said.

“In addition to my efforts to give governors more time and flexibility to adjust to a new system, I’m working with my colleagues to provide governors with a dedicated new funding stream to ensure those using expanded Medicaid resources to treat their addiction can continue to receive treatment as they work to get back on their feet,” Portman said.

Emmalee Kalmbach, a Kasich spokesman, said Kasich “has previously said that he’s willing to consider a reasonable transition to a regular match, but it would depend on states also getting additional flexibility they need to manage their programs.”

But Portman’s plan provoked intense criticism from those who want to retain Medicaid expansion. Amanda Wurst, a spokeswoman for the Alliance for Health Care Security, said Portman “is giving Ohio families a sucker punch in the gut.”

“Taking straight from the disastrous House health care repeal, this proposal repeals Medicaid for almost 700,000 Ohioans, putting health care for seniors, people with disabilities, and children at risk,” Wurst said. “This is a sad and stunning sellout of his Ohio constituents.”

Portman objected to the House bill passed last month. He said while the “status quo” under Obamacare is “unsustainable,” the House bill “does not do enough to protect Ohio’s Medicaid-expansion population, especially those who are receiving treatment for heroin and prescription-drug abuse.”

But with only 52 votes in the Senate, Republicans have little margin for error to produce their own health-care version.

Under the House bill, people who were in the expanded program before 2020 would be grandfathered in, but those dropping out could not return, meaning the number of those people on expanded Medicaid coverage would shrink.

States could continue to provide expanded Medicaid coverage, but would have to pick up more of the costs, which could cost Ohio as much as $1.2 billion a year by 2021.

Obamacare cut the number of people without coverage by 40 percent by expanding Medicaid and providing middle-income people with tax credits to buy individual insurance policies.

Families of four earning between $34,000 and $98,400 a year can receive federal tax credits to buy individual insurance policies through the federal or state marketplaces, known as exchanges.

Like Portman, Kasich opposes the House bill.

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