Of paramount concern in this ongoing and fragmented debate is the phase-out of Medicaid expansion funds. Under the ACA, states were given the opportunity to broadly expand their Medicaid coverage. (Ohio did.) The program has been hailed outside of Republican legislative circles as a success; coverage rates increased in states that expanded Medicaid offerings, and, as the country's opioid addiction crisis worsened, the access to affordable health care stanched to some degree the tragedy.
A recent Associated Press report states: "In Ohio, the expansion accounted for 43 percent of Medicaid spending in 2016 on behavioral health, a category that includes mental health and substance abuse." (The ratio is even higher in some other states, like the 59 percent of Medicaid expansion funds going toward substance abuse treatment in Maryland last year.)
Gov. John Kasich was one of the most vocal Republican supporters of the Affordable Care Act's Medicaid expansion opportunity when he rolled it out in 2014. He used the expanded health coverage program as a sharp dividing line between him and other candidates on the presidential campaign trail last year. Now, faced with an imminent Senate vote on a bill that proposes doing away with that expansion, Kasich is urging caution: "That is a very, very bad idea, because we cannot turn our back on the most vulnerable," he said on CNN.
The AHCA Senate vote, expected next week, comes at a time when all predictions point to an even higher opioid overdose death count than in years past, especially in hard-hit Ohio. And it's not like access to treatment is terrific in the first.
From the AP:
In Youngstown, factory mechanic Paul Wright credits sustained help from Medicaid with his survival after he nearly died from a heroin overdose. Wright said he had started using as a teenager but now has been drug-free for 18 months. Before Medicaid expanded, his father's health insurance would pay for detox but not for long-term treatment. Wright would relapse. With Medicaid, he's been able to get follow-up.
"It's truly sad, but I've been to many funerals since I've been clean," said Wright, who's in his mid-20s. "I just think Medicaid — honestly — it saves people." And he's able to work.
Tomorrow, Ohioans will again gather at Portman's downtown Cleveland office (1240 East 9th St.). The event begins at noon, with speakers delivering pointed presentations to Portman staffers as the vote draws closer.