Americans for Prosperity (AFP), one of the largest conservative activist groups in the United States, held their annual “Defending the American Dream Summit” in Columbus, Ohio, this week, but the state’s Republican Governor John Kasich was not invited.
Kasich’s decision to expand Medicaid under Obamacare—a move that the U.S. Supreme Court ruled was optional and up to state discretion—is a sore subject for fiscal conservatives and led to him being, not just left out of an event held in his backyard, but attacked by several of the event’s speakers, including former Texas Gov. Rick Perry and AFP President Tim Phillips.
Obamacare critics do not like how the law allows Medicaid, originally enacted as a safety net to provide health coverage for poor mothers and children, to be expanded to cover able-bodied, working-age adults. Federal funds cover the costs of the new enrollees but will start scaling back in 2017. Moreover, states are on the hook for administrative costs for signing up the new enrollees, whose numbers have far exceeded estimates.
For fiscal conservatives, like the activists at the AFP conference, the massive spending incurred by Medicaid expansion is especially distasteful, and Kasich’s support of it is viewed as a heretical departure from conservative principles, much like the way school choice advocates view former Florida Gov. Jeb Bush’s support for Common Core.
Kasich has defended his decision to authorize Medicaid expansion in Ohio on religious grounds, a rationale that has fallen flat with conservatives. According to a report by the Cleveland Plain Dealer, when Kasich was questioned about Medicaid expansion at a California conference sponsored by the Koch brothers, AFP’s benefactors, he replied, “When I get to the pearly gates, I’m going to have an answer for what I’ve done for the poor.”
Groups like Watchdog.org, a project of the Franklin Center for Government Accountability, and the Foundation for Government Accountability have joined AFP in criticizing Kasich. Nearly half a million Ohioans signed up under Kasich’s Medicaid expansion, and the plan was already 33 percent over budget in just its first year.
According to Watchdog’s Jason Hart, Ohio’s Medicaid enrollment numbers under Obamacare now exceed 600,000 and have cost taxpayers $4.4 billion.
Phillips, the AFP President, mentioned Kasich’s Medicaid expansion when he addressed the nearly 4,o00 activists on the conference’s first day. Even though he never said Kasich’s name, the implication was clear when he vowed that they would continue to fight against Medicaid expansion: “Whether proposed by a Democrat or a Republican, we’ll continue to oppose it with all we’ve got.”
“President Obama and some Republicans want to take millions of the most vulnerable citizens and they want to throw them into a Medicaid bureaucracy where the care is substandard,” continued Phillips, as the audience cheered in agreement. “They call that compassion. We call it immoral.”
Perry also took a swipe at his fellow Republican presidential contender during his remarks on Saturday. Kasich has repeatedly claimed that the federal funds going to pay for Ohio’s Medicaid expansion “belong” to Ohioans and would be spent in other states if Ohio had not claimed them. Perry rejected this argument as “just nonsense.”
“That money doesn’t come from an endless vault of money in Washington. It is borrowed from bankers in China and children in Cleveland and Columbus,” Perry added. “Justifying Medicaid expansion on the grounds of returning federal money to your home state can only be done if you turn a blind eye to the fact that we are $18 trillion in debt.”
Avik Roy, Senior Advisor to Perry’s presidential campaign and well-regarded as a health care policy expert before joining the campaign, spoke on a well-attended panel Saturday morning on the issue of Medicaid expansion. Like Perry, Roy found Kasich’s justifications wholly unconvincing.
— Avik Roy (@Avik) August 22, 2015
“There’s no more important fight in terms of the expansion of government in this country right now,” said Roy, than the issue of Medicaid expansion. He issued a challenge to Kasich: “Who is going to Hell if we shove 15 million more people in a broken program?”
Follow Sarah Rumpf on Twitter: @rumpfshaker.