Just a few months ago, few would have predicted that John Kasich would be one of the last three candidates standing in the GOP presidential primary. Now, a lot of GOP voters are looking at Kasich with fresh eyes and considering voting for him.
However, that’s not an easy decision for a lot of principled conservatives. Kasich expanded Obamacare in Ohio, and on top of the law being broadly unpopular with the American electorate, it’s particularly unpopular with Republican voters. But given that the GOP frontrunner has repeatedly praised socialized health care, you’d think Kasich’s policy transgression could be overlooked.
Unfortunately, Kasich is making that very, very hard to do. As we saw last night at CNN’s town hall, he sanctimoniously keeps insisting that expanding Medicaid in Ohio to get his hands on Obamacare money was the right thing to do, and he portrayed it as a smart fiscal decision. The former assertion is highly debatable, and the latter is utterly delusional. Here’s the transcript of Kasich explaining himself on CNN [I’ve abbreviated it a bit to make it more germane]:
Now let’s delve into why Kasich’s representation of what he did is objectionable. It’s not just that he expanded Obamacare. In order to do that, Kasich had to do an end run around the GOP-controlled legislature in his own state to expand Medicaid and get access to the corresponding federal Obamacare money to support the move. Kasich got the Medicaid expansion approved through some questionable maneuvering involving the state’s controlling board.
Now let’s be clear here. Medicaid is a terrible program. It’s doing an extremely bad job of getting medical care for the poor, because Medicaid controls costs by continually ratcheting down the reimbursement rates paid to doctors. Only 45 percent of doctors were accepting Medicaid in 2014 — down 10 percent from 2009. It’s not uncommon for Medicaid patients in urban areas to wait months for basic doctor’s appointments.
As a result, health care outcomes for people on Medicaid are often shown to be worse than actually being uninsured:
So as the town hall questioner was right to point out, looking toward Washington for a federal program to actually get the poor health care, as opposed to crappy insurance most doctors don’t accept, is a bad idea. If you were a governor claiming to be a fiscally minded policy guy, you might look at a program to get the poor health care that actually works. That program is not Medicaid.
As for the fiscal part of the equation, Kasich’s blather about bringing “innovation to the system” and rates of increase seems transparently designed to distract voters from the fact that Ohio’s Medicaid expansion is a financial disaster in the making.
Kasich keeps bragging about Ohio’s $2 billion budget surplus, but he’s going to need it to pay for the Medicaid expansion. In two years, the Medicaid expansion in Ohio cost $7 billion
, and the program is on track to double the original fiscal projections by 2020. There’s absolutely no rational argument to support Kasich’s absurd assertion “our Medicaid program is completely under control.”
Which brings us to Kasich’s other rationale for expanding Medicaid — it brought in $14 billion in federal largesse to pay for the expansion. The country is $19 trillion in debt, and while the Ohio governor might want to care for Ohio’s poor, that Medicaid expansion is being paid for with federal deficit spending that inevitably burdens taxpayers in other states who have their own poor citizens to take care of.
Finally, and this is what many people find especially galling, Kasich keeps framing his decision as a matter of compassion. At a later question in the same town hall, Kasich cites the Obamacare expansion as an example of “moral courage in the face of public opposition.” The clear implication is that those who oppose Kasich’s decision just don’t care about the poor as much as he does.
He’s been pretty explicit about this and has invoked his faith to defend it.
“Now, when you die and get to the meeting with St. Peter, he’s probably not going to ask you much about what you did about keeping government small,” he said, defending the Medicaid expansion. “But he is going to ask you what you did for the poor. You better have a good answer. ”
Invoking Christianity to justify supporting a failing federal program with money you don’t have is downright offensive. (And it’s especially baffling because Kasich has an extremely narrow view of religious liberty; Kasich’s Jesus would compel you to pay for Medicaid and force you to bake gay wedding cakes.)
In sum, the basic facts make Kasich’s Obamacare expansion unsupportable on the grounds of effective policy, fiscal responsibility, and moral authority. It’s possibly the most liberal position ever articulated and defended by a major GOP presidential candidate in the last several decades.
If Romney’s proto-Obamacare health care plan in Massachusetts was disqualifying in the eyes of many conservative voters and that lack of enthusiasm hurt him as a candidate, this is much, much worse. Romney at least tried to spin what he did as being amenable to conservatives. Kasich appears to be doubling down every chance he gets. I don’t see a scenario where more scrutiny is brought to bear on what Kasich did and it doesn’t end up turning off the same Republican voters he needs to court.
