Republicans Might Be Mad at John Kasich, But Voters Won’t Be

The Ohio governor’s decision to ignore GOP objections and expand Medicaid improves his odds in 2014 (and 2016 too).

TAMPA, FL - AUGUST 28: Ohio Gov. John Kasich speaks during the Republican National Convention at the Tampa Bay Times Forum on August 28, 2012 in Tampa, Florida. Today is the first full session of the RNC after the start was delayed due to Tropical Storm Isaac. 
National Journal
Jill Lawrence
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Jill Lawrence
Oct. 23, 2013, 1 a.m.

Ohio Gov. John Kasich has kicked up a polit­ic­al storm by cir­cum­vent­ing his le­gis­lature to ex­pand Medi­caid un­der the Af­ford­able Care Act. Con­ser­vat­ives don’t like Obama­care, the ex­pan­sion, or the tech­niques by which their de­term­ined Re­pub­lic­an gov­ernor made it hap­pen, and they’re already chal­len­ging him in court. Yet Kasich may have strengthened his hand go­ing in­to his 2014 reelec­tion race. And should he de­cide to pur­sue high­er am­bi­tions, a sol­id vic­tory next year in his purple pres­id­en­tial swing state could hasten for­give­ness from GOP primary voters — or a nom­in­ee in search of a tick­et­mate — in 2016.

The Re­pub­lic­an-con­trolled le­gis­lature in Ohio made clear it did not want to ac­cept some $2.56 bil­lion in fed­er­al money un­der the Af­ford­able Care Act, even in­clud­ing in the state budget a pro­vi­sion that said Kasich could not en­act the ex­pan­sion without le­gis­lat­ive ap­prov­al. But Kasich ex­cised that pro­vi­sion with his line-item veto — then asked an ob­scure sev­en-per­son pan­el ap­poin­ted by le­gis­lat­ive lead­ers, the Con­trolling Board, to ap­prove ac­cept­ance of the fed­er­al money. The vote was 5-2, with a ma­jor­ity of two Demo­crat­ic law­makers, two Re­pub­lic­an law­makers, and an ap­pointee from Kasich’s of­fice. The up­shot is that some 275,00 low-in­come people will get health in­sur­ance through Medi­caid, an ex­pan­sion the fed­er­al gov­ern­ment has pledged to un­der­write 100 per­cent for three years and 90 per­cent there­after.

Kasich has been mak­ing the case for the ex­pan­sion for months, us­ing mul­tiple ar­gu­ments. Like many gov­ernors, he says it will re­duce un­com­pensated care at hos­pit­als and keep health jobs in the state. Kasich also has re­peatedly in­voked a less com­mon ar­gu­ment — re­li­gious faith — in call­ing for the ex­pan­sion. He re­cently called it “a mor­al im­per­at­ive.” He once told a fel­low con­ser­vat­ive that St. Peter prob­ably wasn’t go­ing to ask him what he did to keep gov­ern­ment small, “but he’s go­ing to ask you what you did for the poor. You bet­ter have a good an­swer.”

That’s not a re­mark de­signed to win friends, and Kasich con­cedes the point. He told re­port­ers in June that he was be­ing “some­times pleas­antly per­sist­ent and maybe per­sist­ent without all the pleas­ant­ness” at times in push­ing for the ex­pan­sion. How de­term­ined was he? “I will not give up this fight ‘til we get this done. Peri­od. Ex­clam­a­tion point.”

GOP strategists say Kasich is not tak­ing much of a polit­ic­al risk with his Medi­caid ad­vocacy. A private poll of Ohio earli­er this year found an over­whelm­ing ma­jor­ity in fa­vor of it, though Re­pub­lic­ans were di­vided. Some don’t trust the fed­er­al gov­ern­ment to keep up its end of the fin­an­cial bar­gain and oth­ers are hold­ing out for re­forms in the Ohio pro­gram, some of which are ex­pec­ted to pass. “It’s too early to tell what kind of erosion he’ll have in his base, be­cause some people are ir­rit­ated,” says Re­pub­lic­an Neil Clark, a Colum­bus lob­by­ist who has known Kasich since 1980. He pre­dicted that Re­pub­lic­ans will ul­ti­mately put this factor in­to per­spect­ive as part of a “total pack­age” that in­cludes tax cuts, job cre­ation, edu­ca­tion fund­ing, and sta­bil­ized tu­ition fees.

More than three dozen Re­pub­lic­an law­makers form­ally pro­tested Kasich’s de­cision to go to the Con­trolling Board, and the tea-party in­fused 1851 Cen­ter for Con­sti­tu­tion­al Law on Tues­day filed a leg­al chal­lenge at the Ohio Su­preme Court on be­half of sev­er­al of them. Maurice Thompson, ex­ec­ut­ive dir­ect­or of the group, said it is less con­cerned about the Medi­caid ex­pan­sion than the prin­ciple of lim­it­ing the au­thor­ity of the Con­trolling Board. “Our lit­ig­a­tion is strictly about the sep­ar­a­tion of powers and the checks and bal­ances in Ohio,” he said this week. The law­suit asks the board to re­verse its de­cision.

Twenty-five states and the Dis­trict of Columbia have now chosen to ex­pand Medi­caid un­der the Af­ford­able Care Act to 138 per­cent of poverty level, which is less than $16,000 for an in­di­vidu­al. Ac­cord­ing to the Na­tion­al Con­fer­ence of State Le­gis­latures, only four of the ex­pan­sions are hap­pen­ing without le­gis­lat­ive ap­prov­al: West Vir­gin­ia, Ken­tucky, Ohio, and Ver­mont (which already had ex­pan­ded cov­er­age and didn’t need to change its law).

Ken­tucky Gov. Steve Be­s­hear stirred con­tro­versy with his move, for in­stance, but has little at stake polit­ic­ally. He is 69, a Demo­crat more than halfway through his second term in a con­ser­vat­ive state, and un­der state law can­not run for a third. He has not dis­played any dis­cern­ible in­terest in a na­tion­al polit­ic­al ca­reer. Kasich, on the oth­er hand, briefly toyed with a pres­id­en­tial run in 1999 and now leads one of the two or three states most coveted in White House elec­tions.

The son of a mail­man, he has stayed in touch with his blue-col­lar roots even after a stint as an in­vest­ment banker at Leh­man Broth­ers, be­fore its col­lapse. That is part of what has colored his ap­proach to Medi­caid. In his ex­traordin­ary ex­change with re­port­ers in June, Kasich went from talk­ing about St. Peter and his in­tent to fight, to this: “You know, be­cause people are poor doesn’t mean they don’t work hard. Be­cause people are poor “¦ it some­times means they couldn’t pull them­selves up by their boot­straps at some point in time. The most im­port­ant thing for this le­gis­lature to think about: Put your­self in some­body else’s shoes. Put your­self in the shoes of a moth­er and a fath­er with an adult child that’s strug­gling. Walk in some­body else’s moc­cas­ins. Un­der­stand that, you know, poverty is real.”

The re­marks bring to mind Mitt Rom­ney’s mono­logue about the ir­re­spons­ib­il­ity of the “47 per­cent.” It’s a stark con­trast and one that could serve Kasich well if he de­cides, down the road, that 2016 is his time.

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