Gov. John Kasich (R-OH) has a simple question for Republican lawmakers reticent to take part in Obamacare’s Medicaid expansion: “What would Reagan do?” The answer, according to Kasich, is also simple — expand Medicaid.
In an editorial for USA Today, Kasich — who became the fifth Republican governor to endorse expansion in February — noted the irony of GOP state lawmakers citing Reagan’s fiscal conservatism in order to justify their opposition to the health law provision, arguing that Reagan had expanded Medicaid on several occasions:
Leaders in the states that have decided against expanding have often invoked Reagan conservatism as the reason to oppose extending Medicaid health care coverage to more people. After all, doesn’t Reagan embody modern conservatism? He cut taxes, cut government red tape and fought the growth of entitlements.
Yes, he did all those things. However, he also expanded Medicaid, not just once but several times.
For example, in 1986, President Reagan let states add poor children and pregnant women to Medicaid. And after learning that disabled children could receive Medicaid care only in hospitals and nursing homes, he let states provide them care at home also. Ohio resisted both expansions for a decade but saw powerful results for some of our most vulnerable citizens once we made them.
The governor is right on the facts. Reagan signed the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986. The law bars hospitals from turning away patients based on their insurance or citizenship status; shortly thereafter, Reagan authorized a special annual Medicaid fund that largely subsidizes the cost of low-income or undocumented pregnant women who give birth in hospitals, as well as their young children’s medical bills. In fact, the federal Medicaid budget actually doubled over the course of Reagan’s presidency.
Kasich has been on the road lobbying for Obamacare’s Medicaid expansion, citing his faith and making the fiscal argument that low-income Ohioans and hospitals that serve poor families will benefit immensely from expanding the program. Independent analyses have found that Ohio is one of the states that would be most positively impacted by the expansion, with the Kaiser Family Foundation (KFF) estimating that participation will reduce Ohio’s uninsurance rate by almost 61 percent.
Although conservatives often dismiss Obamacare as a “government takeover of health care,” the fact is that many aspects of the health law are strikingly similar to Reagan-era proposals. For example, Reagan implemented a system of price controls to Medicare hospital payments that moved it to a system of fixed payments and ended up saving the program $49 billion by 1986. Obamacare contains similar provisions which reward providers that are able to improve patient health while lowering Medicare spending. Recently-released government data suggest this provision has already led to systemic changes in U.S. health care that has extended Medicare’s solvency.