Ohio Gov. John Kasich, who campaigned as a limited government Republican, on Monday announced that he would implement one of the costliest provisions of President Obama’s health care law by expanding the state’s Medicaid program. His decision, a huge victory for the White House that will provide cover for more Republican governors to do the same, serves as a great case study on how difficult it is to impede the growth of government.
When Obamacare was making its way through Congress in 2009 and 2010, the proposed expansion of Medicaid was one of its most controversial elements. As things stood, the program was crushing state budgets, so governors in both parties feared that expanding it to 15 million to 18 million beneficial would be unsustainable. Then Sen. Ben Nelson was infamously given the “Cornhusker Kickback” — expanded federal funding for Medicaid to Nebraska — to win help secure the 60th vote to get Obamacare through the Senate.
The backlash against the “Cornhusker Kickback” cemented the idea in the public consciousness that the process used to pass Obamacare was corrupt, helped elect Scott Brown to the Senate in Massachusetts and added fuel to the Tea Party. Ultimately, lawmakers substituted the special Medicaid treatment for Nebraska in favor of increased federal funding for all states instead. Under the law, the federal government will pay 100 percent of the cost of the Medicaid expansion at first, and then 90 percent after 2020. This comes at a cost to federal taxpayers — $932 billion over a decade, according to the Congressional Budget Office. To be clear, that’s if all states participate. But last year, 26 states led by Florida won a suit challenging the federal government for coercing states into the Medicaid expansion and the Supreme Court left states with the option of rejecting it. This brings us back to Kasich and his decision.
Kasich was the Republican House Budget Committee Chairman during the Clinton-Gingrich government shutdown fights of the 1990s and a former guest host for Bill O’Reilly. He rode the backlash against big government into the Ohio governor’s mansion in 2010. A regular speaker at Tea Party rallies, Kasich boasted, “I think I was in the Tea Party before there was a Tea Party.” Days before his election in 2010, he argued, “Obamacare must be blocked.”
This morning, Kasich announced he was joining four other Republican governors in agreeing to expand Medicaid under Obamacare and pass the bill on to federal taxpayers. “It makes great sense for the state of Ohio because it will allow us to provide greater care with our own dollars,” he said at a news conference, as reported by the Huffington Post’s Jeffrey Young.
Whatever justifications Kasich may give, the actual explanation for his embrace of the Medicaid expansion is political cowardice. Chastened by his failed attempt at public sector union reform and Obama’s victory in the state, Kasich is up for reelection next year. And he’s afraid to stand up to the inevitable onslaught of attacks from Democrats who would charge that he was refusing to accept free money to bring health care to poor Ohioans. The end result is that a politician who ran for office claiming to have been “in the Tea Party before there was a Tea Party” is now actively embracing a policy that the Tea Party movement was born to oppose.
This should serve as a sober reminder to conservatives that no matter how big of a disaster Obamacare is when it’s implemented in 2014, the nation is almost certainly stuck with it. More broadly, it’s a demonstration of how difficult it is to defeat big government.