Controlling Board membership may be altered to provide okay for Medicaid expansion

It looks like Gov. John Kasich will get his Medicaid expansion approved by the Controlling Board.

I previously shared with you his plans to bypass the Ohio General Assembly, which had removed the expansion from prior bills and is still debating the issue.

Last week, the Department of Medicaid submitted a request to the panel seeking authorization to spend federal funds totaling $500,000 million in FY14 and $2 billion in FY15 to extend the program to cover citizens up to 138% of the federal poverty level, as originally proposed by Gov. John Kasich in his biennium budget bill.

The item is scheduled for the Controlling Board's meeting on Oct. 21.

The Controlling Board is a 7-member body comprised of:

• The Director of Budget and Management, or designee (the President of the Board)
• The Chair of the Finance and Appropriations Committee of the House of Representatives
• The Chair of the Finance Committee of the Senate
• Two members of the House appointed by the Speaker of the House, one from the majority party and one from the minority party
• Two members of the Senate appointed by the President of the Senate, one from the majority party and one from the minority party

In order for the expansion to be approved, at least one Republican would need to vote in favor of it. The two House Republicans have previously expressed opposition to the plan, but the two Republican Senators have been silent on the matter.

Today Gongwer Ohio (subscription may be required) reported that House Speaker Bill Batchelder (R-Medina) "plans to alter his chamber's membership on the panel prior to next Monday's meeting and will seat at least one member that will give the go-ahead to the governor's plan."

Rep. Ron Amstutz expressed his displeasure with the governor's Controlling Board move last week. Rep. Cliff Rosenberger said he would vote against expansion at the Controlling Board, and told Gongwer he hadn't heard of any plans to replace him on the panel.

From Gongwer:

Rep. Rosenberger said he'd prefer to continue to debate the policy through the full legislature but added that he has been on record as opposing a straight expansion and instead prefers the "reform" approach embodied in various proposals, including the bill (SB 208*) introduced last week by Sen. David Burke (R-Marysville). (See Gongwer Ohio Report, October 10, 2013)

"There's an opportunity for members of the General Assembly to still hear those options," he said, adding that he's concerns about the impact of pushing the expansion through the board versus the legislature.

"I would be a 'no' vote on the Controlling Board on the issue," Rep. Rosenberger said.

While Speaker Batchelder has been a staunch opponent to expansion, as it was part of the vilified "Obamacare" package, swapping out his reluctant Controlling Board members could prove to be politically expedient as it would provide cover to some of his caucus members who support expansion.

A Controlling Board vote averts putting those members on record for where they stand on separate legislation, thus protecting them from potential primary challenges from the right. Meanwhile, he's also boosting the policy aims of his fellow Republican governor, whose name is being bandied about as a presidential candidate in 2016.

Also a matter of conventional wisdom: Gov. Kasich wouldn't have scheduled a Controlling Board item if he wasn't assured of the votes.

Senate President Keith Faber (R-Celina) said in an interview Tuesday that his caucus is aware of his opposition to expansion, however he has told his members on the panel - Sen. Bill Coley (R-Liberty Twp.) and Sen. Chris Widener (R-Springfield) - to vote their conscience and their districts.

Nevertheless, he also said he doesn't view the proposal before the board to be the actual "expansion," per se. That would come through an executive order from the governor, he said. The Controlling Board agenda item would merely authorize the transfer of funds.

Kasich has been criticized by conservatives in the state for his plan to expand Medicaid. Here is guest post that details the 'myths' associated with the expansion, as promoted by the Kasich administration talking points on the plan.

Others, including State Rep. Barbara Sears, left-leaning groups and many Democrats, support the expansion of the government program.

Had this been Democrats planning to replace board members in order to provide a favorable vote for their governor, I'm sure the Republican Party would be having a conniption. As it's a Republican governor, expect the party to stand behind their man, regardless of party principles.

Guest Post: The Myths of Medicaid Expansion

The following is a guest post from Rep. Ron Young, Republican from Leroy Township, District 61.

I believe Ronald Reagan summed up what we face today way back in 1961. He said, “In 1927 an American socialist, Norman Thomas, six time candidate for president on the Socialist Party ticket, said the American people would never vote for socialism. But he said under the name of liberalism the American people will adopt every fragment of the socialist program. One of the traditional methods of imposing socialism on a people has been by way of medicine. It's very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can't afford it.”

Today, our nation and Ohio are experiencing an expansion of government intrusion into our health care industry of unparalleled magnitude. Full implementation of Obamacare will mean about one- sixth of our nation’s total economy will fall under even tighter government regulation and bureaucracy. 

My comments in this report are focused on the impacts of expanding the Medicaid program. Contrary to some reports, it is impossible to oppose Obamacare and yet support Medicaid expansion. Medicaid expansion is a major part of Obamacare and represents about half of all Obamacare spending. 

In order to understand why Medicaid expansion is bad for Ohio, we need to first understand a few points about the current Medicaid program. 

• About two million Ohioans are on the Medicaid program today, or about 20 percent of Ohio’s total population.
• The current program is by far the biggest expense of the state’s budget, consuming about 42% of it, because Medicaid spending increases much faster than inflation. It is crowding out education, infrastructure improvements, prison funding, and other critical needs. The current program, even without expansion, is financially unsustainable
• The program has been in effect for more than 40 years and is designed to care for pregnant women, children and individuals with disabilities of low or no income. Medicaid expansion is designed to a different population, healthy individuals who fall below the poverty line. The largest group in this population is comprised of single young adults with no dependent children. Of course, this begs the question, are we incentivizing people not to work?  

Former Speaker of the House Nancy Pelosi is famous for her statement regarding Obamacare, “We have to pass this bill so we can find out what’s in it.” However, I believe one of her even more insightful quotes is, "Think of an economy where people could be an artist or a photographer or a writer without worrying about keeping their day job in order to have health insurance."  

 

Her vision of incentivizing unemployment to create an underclass of starving artists is absurd. However, while operating an employment firm in Ohio for more than 30 years, I can recall numerous occasions where individuals rejected job offers and even promotions in order to retain government benefits. Incentivizing unemployment and underemployment is a real problem with the Medicaid program. 

MEDICAID MYTH BUSTING 

In an effort to win public support, a number of myths have been perpetrated regarding Medicaid expansion. By contrasting some of these myths with reality I believe a clearer portrait of the effects of Medicaid expansion can be seen.  

MYTH #1: “Medicaid offers good health care and expanding Medicaid will save countless lives.” 

REALITY: The health outcomes for those our government places on Medicaid are poor and the best research supports this statement. It should not be surprising that Medicaid offers sub-par medical services. Medicaid patients have a significant problem getting access to medical care. One major reason for lack of access is that Medicaid pays doctors only a fraction of what private insurers pay. According to a Heritage Foundation 2012 study, “Medicaid Patients Have Worse Access and Outcomes than the Privately Insured,” Medicaid typically pays physicians only 56% of the amount private insurers pay. Other studies indicate that for a physician in Ohio practicing in an office setting the reimbursement average for Medicaid is even lower. 

As a result, many doctors choose not to see Medicaid patients because it is more difficult to keep their practices alive if they do. That, in turn, makes it hard for Medicaid patients to get doctor’s appointments for annual checkups, routine care, and even urgent medical problems. A 2011 study published in the New England Journal of Medicine found that many doctors even refuse to see Medicaid children complaining of seizures, uncontrolled asthma, and even broken arms.  

These types of access problems also cause huge overcrowding issues in hospital emergency rooms. Since they have difficulty finding available doctors, Medicaid recipients visit emergency rooms at much higher rates than the uninsured. According a study reported in USA Today, “Uninsured Don’t Go to the ER more than the Insured” by Mary Brophy Marcus, Medicaid recipients visit the ER about twice as much as the uninsured.  

After reviewing the research described below I hope each reader will ask a simple question. Is it moral to promote a health program that consumes hundreds of billions of taxpayer dollars, but offers such questionable health outcomes? 

RESEARCH 

University of Virginia Study: A very large study by the University of Virginia found that surgical patients on Medicaid are 13% more likely to die during their hospital stay than those with no insurance coverage and 97% more likely to die than those with private insurance. The Virginia group evaluated 893,658 major surgical operations from the Nationwide Inpatient Sample database from 2003 to 2007. They adjusted the database in order to control for age, gender, income, geographic region, operation, and co-morbid conditions (having 2 or more diseases simultaneously). That way, they corrected for the obvious differences in the patient populations (for example, older and poorer patients being more likely to have ill health). 

Oregon Study: The 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided an opportunity to evaluate the health impacts of the expansion. Approximately 2 years after the lottery, data was obtained from 6387 adults who won the lottery and received Medicaid coverage. Data on health outcomes was also collected on 5842 adults who lost the lottery and did not receive Medicaid coverage. This randomized and controlled two year study that was published in the prestigious Harvard School of Public Health showed that Medicaid coverage generated no significant improvements in measured physical health outcomes. 

A University of Pennsylvania study published in Cancer found that, in patients undergoing surgery for colon cancer, the mortality rate was 2.8% for Medicaid patients, 2.2% for uninsured patients, and 0.9% for those with private insurance. The rate of surgical complications was highest for Medicaid at 26.7%, as compared to 24.5% for the uninsured and 21.2% for the privately insured. 

A Columbia-Cornell study in the Journal of Vascular Surgery examined outcomes for vascular disease. Patients with clogged blood vessels in their legs or clogged carotid arteries (the arteries of the neck that feed the brain) fared worse on Medicaid than did the uninsured; Medicaid patients outperformed the uninsured if they had abdominal aortic aneurysms. 

A Harvard Study suggests there are some instances where Medicaid coverage may save lives. The authors compared three states that expanded their Medicaid programs — Maine, Arizona, and New York — with neighboring states that did not — New Hampshire, Nevada and New Mexico, and Pennsylvania. The Medicaid expansion was associated with increased mortality in Maine, and with decreased mortality in Arizona and New York. 

While the results suggest Medicaid could be helpful in some instances the study has problems. For example, demographic differences between New York and Pennsylvania could explain the entirety of the “benefit” that the authors ascribed to New York’s Medicaid program. Yet the authors’ conclusion — that Medicaid saves lives — hinges entirely on the comparison of New York with Pennsylvania. Without it, the authors would have shown no difference in outcomes between those with Medicaid and the uninsured, because the results in Maine and Arizona would have canceled each other out. 

Another obvious problem with the study is that the Harvard economists looked only at county- level data about mortality and Medicaid; they had to make assumptions about which patients had enrolled in the program, and when. The extensive clinical research showing Medicaid’s poor outcomes, such as the UVA study, has reviewed millions of individual patient records to learn what happened to specific patients with specific forms of health insurance. 

MYTH #2: “If we don't expand Medicaid Ohio will lose federal tax dollars that are earmarked for us. It would be foolish of Ohio to turn down all these free federal dollars."

REALITY: There are no federal Medicaid dollars earmarked for Ohio and it is not free money. There is no pot of gold with Ohio's name on it in Washington waiting to be dispersed the day we expand Medicaid. Most of the money we would receive from the federal government by expanding Medicaid would simply increase the national debt. Many members of the Ohio General Assembly are constantly bemoaning excessive and out of control federal spending. This is reasonable given the fact our federal government is currently more than $16 trillion in debt and going deeper in debt every day. Not only do they not have a balanced budget, they don't even have a real budget. To expand Medicaid only makes the hole this nation is digging for our grandkids deeper. 

MYTH #3: “The federal government has made some great promises to Ohio in the form of special dollar matches if we expand our Medicaid program. The federal government funds about 62% of Ohio’s current Medicaid program. For the expanded program they have promised to pay 100% of the cost of the program for 3 years and 90% of the cost thereafter. A promise from our federal government is rock solid. They have to live up to their promises; we should trust them and take the deal.”  

REALITY: There are no iron clad guarantees in any of the promises offered by the federal government. The federal government can change the Medicaid match amount at any time. To accept Medicaid expansion means Ohio is trusting its financial future to a government that is deeply in debt and addicted to over spending. The calls for a balanced federal budget and entitlement cuts should send a chilling message to those that would support the expansion. Also, we must consider potential changes caused by future administrations. Remember Medicaid is not a road project, or some other short term building project. No one foresees an end date for Medicaid. Whatever budget sources we use to fund the program must be deep, dependable and wide.  The current program is growing so rapidly that its cost is often described as unsustainable. Expanding the program now by signing on hundreds of thousands of new participants would be irresponsible.  Perhaps the old saying, "today's promises are tomorrows taxes" applies in this case as new revenue would have to be found to sustain the program at some point in the future. In any case the long term commitments required to make this deal even somewhat financially feasible are very dubious. 

MYTH 4: “If the expansion program doesn’t work then we’ll just shut it down and walk away.”

REALITY: We could probably argue all day about how Health and Human Services, the courts, a future Governor, a future President, a future Secretary of Health and Human Services, etc., might interpret the law. Most of the “experts” seem to agree that once a state accepts the federal offer and expands Medicaid there is no easy withdraw from the expansion portions of the program. However, I believe the legal argument is a moot point. The reality is that Ohio would simply not drop hundreds of thousands of voting citizens from a Medicaid program. We do not have the political will to do such a thing. Just consider the political pressure being applied today for expanding the program and then consider how much greater that pressure would be if the subject of the discussion was one of taking it away. 

MYTH 5: “We will use the expansion of Medicaid as an opportunity to reform the program.”  

REALITY: It defies logic to expand a government program that needs to be reformed. If we can meaningfully reform Medicaid we should start with the existing program. After the reforms are in place and operating effectively then, and only then, should we consider expansion. 

CONCLUSION: Regardless of the sweeping rhetoric and marketing techniques used by those that support Medicaid expansion the science to support claims of significant improvements in public health are not supported by the facts. How many lives and families could be saved by leaving these billions of dollars in the private sector to create jobs and expand our economy, as opposed to burdening the nation with more debt and bigger government in order to expand a very questionable, if not failed, government program? 

UPDATED: Kasich seeks Controlling Board approval for Medicaid expansion

Gongwer is reporting that Ohio Gov. John Kasich's administration will seek approval from the Controlling Board to expand Medicaid up to 138% of the federal poverty level.

The Department of Medicaid on Friday submitted a request to the panel seeking authorization to spend federal funds totaling $500,000 million in FY14 and $2 billion in FY15 to extend the program to cover citizens up to 138% of the federal poverty level, as originally proposed by Gov. John Kasich in his biennium budget bill.

The Controlling Board’s next meeting is Oct. 21. GOP legislative leaders have thus far been coy about providing votes for the plan; at least one Republican vote will be needed to clear the spending through the seven-member panel.

“Only the General Assembly can authorize Medicaid to spend funds in this way, either through a bill or the Controlling Board,” Kasich spokesman Rob Nichols said in an email. “The Administration has been preparing to implement this change when the General Assembly gives its ok and we’ll be ready.”

Despite the shutdown, federal officials approved Ohio’s proposal to expand the entitlement program earlier this week...apparently, such approval is an 'essential' function of government.

See Jason Hart's post at MediaTrackers for more background on the continuing saga.

UPDATE: Statement from Chairman of the House Finance and Appropriations Committee and member of the State Controlling Board Ron Amstutz (R-Wooster):

"I have grave concerns about the place, the time and the substance of this proposed Controlling Board action. Based on our solid track record of passing tough bills, I would expect a far superior and more creative solution by legislative enactment than what I fear may result from effectively crimping the legislative process."

Guest Post - Oops! A whopping $47B Obamacare-Medicaid expansion error for Ohio

Opportunity Ohio found a whopping error in the recent claims that expanding Medicaid in Ohio would save us money. Aside from the fact that adding more people into a program cannot possibly result in less cost, the key is capping the rates. But what if we cap the rates and don't expand Medicaid?

As the Bard says, "Aye, there's the rub."

Here's the text of the report. For the full details, including footnotes, go here.

A number of individuals have falsely characterized a recent PowerPoint presentation given to the Ohio Senate Finance Committee’s Medicaid Subcommittee by the Health Policy Institute of Ohio (HPIO).

The Columbus Dispatch flashed a headline that erroneously claims the presentation proved “Medicaid expansion would cost Ohio less than doing nothing.” The Dispatch’s editorial board followed up by asserting that the presentation proved that expanding Medicaid would “save the state money in the long term.” The Columbus Business First reported that the presentation showed that “Ohio could actually save by expanding Medicaid.” These headlines and reports would have Ohioans believe expanding one of the largest and fastest-growing line items in the state budget can reduce spending. But this is not what the HPIO actually found.

The authors created three different scenarios. In the first scenario, Ohio does not expand Medicaid and the program grows at 7.2 percent annually, what HPIO reports as the average annual growth rate since 2004. It should be noted that in a report released earlier this year, HPIO expected future Medicaid growth to average 5.6 percent per year without expansion, based on Ohio’s most recent actuarial analysis of Medicaid. It does not explain why it now assumes 7.2 percent growth as the baseline (without expansion) moving forward.

In the second scenario, Ohio caps its annual Medicaid spending growth at 5 percent and also expands Medicaid eligibility. In the final scenario, Ohio caps its annual Medicaid spending growth at 4.5 percent while also expanding Medicaid eligibility. Capping Medicaid spending growth is not related to expanding Medicaid eligibility. If Ohio wished to impose such a cap, it could do so without expanding Medicaid. The only valid comparison is one in which the only changing variable is whether or not the state expands Medicaid eligibility.

For example, the presentation asserts that by capping annual Medicaid spending growth at 5 percent, Ohio can expand Medicaid and still save $2 billion between now and 2025, when compared to 7.2 percent annual growth. But, using that same data, Ohio could save more than $48 billion during the same time period by capping annual growth at 5 percent and not expanding Medicaid eligibility. So, when using an honest comparison, Medicaid expansion will actually increase taxpayers’ costs by $46 billion, even if the state is able to aggressively reduce annual growth.

Choosing not to provide any specific recommendations to reduce the annual growth in Medicaid, HPIO instead provides a listing of possible new revenues to offset higher costs. Of course, increasing revenues does not lower spending. But even at the assumed lower annual growth rates, Medicaid spending would still double within the next 15 years. For comparison, the U.S. economy is expected to grow only 4.9 percent during the next decade. Ohio can expect to see slower growth, as the U.S. economy has historically grown 1.5 times as fast as Ohio’s economy.  If this trend continues, Ohio’s economy will grow by just 3.3 percent during the next decade. The Ohio Department of Development also expects Ohio’s economy to grow slower than the national average in the coming years.

This means Medicaid will continue to consume more and more funding, crowding out resources for other state priorities, even under the HPIO’s assumed lower Medicaid growth rates. Worse yet, the HPIO spending projections are based on the same flawed designs highlighted in a  Foundation for Government Accountability-Opportunity Ohio report published earlier this year. For example, HPIO uses Medicaid managed care rates for current adult enrollees to estimate the costs of covering newly-eligible individuals. However, evidence from states that previously expanded Medicaid eligibility to cover working-age adults without children found this population to be much more expensive to cover than parents. Additional research published by the federal Centers for Medicare and Medicaid Services found that costs were an average of 60 percent higher to provide the same benefits package to childless adults as they were for low- income parents.

HPIO flawed analysis is also evident in its assumption that just 58 percent of all newly-eligible individuals will sign up for Medicaid after expansion. Even among the uninsured, HPIO assumes just 70 percent of newly-eligible individuals will enroll. These are much lower than other projections of participation, including projections by actuaries at the Centers for Medicare and Medicaid Services. States that have previously expanded Medicaid to cover working-age adults without children also relied on projections similar to those given by HPIO.  Those states experienced participation rates that far exceeded what was initially expected.

The HPIO presentation given to the Medicaid Subcommittee adds very little to the debate over Medicaid expansion in Ohio. It recycles old projections based upon faulty assumptions. The only “new” material is the conclusion that capping the annual growth in Medicaid spending will reduce total Medicaid spending, but this has no relevance to the debate at hand. Such a cap has nothing to do with Medicaid expansion, and conflating the two is intellectually dishonest. When comparing apples to apples, where the only changing variable is whether or not the state expands Medicaid, the only valid and fact-based conclusion is that Medicaid expansion will cost taxpayers much more.”

AFP-Ohio says Rep. Sears and Pres. Obama are the same when it comes to Medicaid expansion

Press release from Americans for Prosperity - Ohio:

Americans for Prosperity-Ohio: No Difference Between Rep. Sears’ and President Obama on Medicaid Expansion 

COLUMBUS - Americans for Prosperity – Ohio is expressing their strong opposition to proposed legislation aimed at expanding Medicaid in the state of Ohio.  According to a recent Columbus Dispatch story, Rep. Barbara Sears (R-47) plans to introduce roughly a dozen Medicaid bills in the next few weeks with the end-goal of expanding Medicaid in the state.  The expansion of Medicaid is made possible through Obamacare.

“Rep. Sears and President Obama are both calling for the expansion of the Medicaid system.  How many blank checks and empty promises are we going to allow Washington to pass onto the states before we stop falling for it?,” said Eli Miller, State Director of Americans for Prosperity – Ohio. “The federal government can barely meet its current financial obligations.  We cannot allow Ohio families and businesses to be left holding the bag when, not if, the federal government realizes they cannot meet the financial obligations promised surrounding Medicaid expansion.”

According to the Columbus Dispatch story, Medicaid expansion legislation would need to pass the Ohio General Assembly in October of this year so that enrollment could begin in January 2014.

“At a time when even the Obama Administration is essentially admitting defeat by delaying key provisions of Obamacare, Rep. Sears should not recklessly and irresponsibly tie our state’s finances and the physical health and well-being of our most vulnerable citizens to this eventual disaster,” continued Miller. “We call on all members of the Ohio General Assembly to support Ohio families, stand up for fiscal responsibility, and oppose Rep. Sears and President Obama’s Medicaid expansion.”

Americans for Prosperity (AFP) is a nationwide organization of citizen-leaders committed to advancing every individual’s right to economic freedom and opportunity. AFP believes reducing the size and intrusiveness of government is the best way to promote individual productivity and prosperity for all Americans.  For more information, visit www.americansforprosperity.org

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Kasich, new TV ads, Obamacare and Medicaid expansion in Ohio

Despite the fact that it's summer when political things usually slow down, there's a lot of activity going on when it comes to Medicaid and Obamacare...

At a rally yesterday in Columbus, Ohio Gov. John Kasich continued his push for an expansion of Medicaid and enrolling up to 366,000 new members by the end of the year.

The General Assembly rejected this expansion as part of the state's two-year budget which they passed last month.

Jason Hart at MediaTrackers has good coverage of the event starting with:

Governor John Kasich stuck to his practiced Medicaid expansion pitch – a mix of progressive pseudo-Christianity and outright falsehoods about the program’s funding – during a speech at a July 9 Statehouse rally for socialized medicine.

As his administration has done for months, the Republican governor conflated Medicaid coverage with “health care,” though 28 percent of Ohio’s office-based physicians were already refusing new Medicaid patients in 2011 and a recent study found that Medicaid coverage does not improve physical health.

Americans for Prosperity - Ohio, one of the leading critics of expanding the state's Medicaid rolls (as allowed under law), argues that expanding Medicaid rolls will push thousands of low-income Ohioans into a shoddy system at enormous cost.

"AFP will continue to educate Ohioans about the problems with Medicaid expansion. Ohioans need more health care choices, not more sub-par, bureaucrat-controlled health care and higher taxes," Eli Miller, State Director of AFP-Ohio, said.

Also yesterday, in conjunction with the AFP-Ohio efforts, broadcast and cable networks in Ohio started airing a new ad from Americans for Prosperity. The goal of the ad is to "expose the major problems with the Pres. Obama's health care law, the Affordable Care Act also known as Obamacare."

It's called “Questions,” and features the story of Julie, a mother of two who started paying close attention to her family’s health care options after her son began having seizures. The threat of shrinking options, higher premiums, and Washington bureaucrats making health care decisions leaves her with serious concerns about ObamaCare.



"The American people have serious questions and concerns about the negative impact of ObamaCare," Miller said."Ohioans are waking up to higher premiums and fewer choices, but are being told by President Obama and outside groups that everything is just fine. Well President Obama, everything isn't just fine. We feel it is important to educate Ohioans on the true consequences of government intrusion into the private health care decisions of families."

AFP-OH and state chapters across the nation plan to host events and meet-ups to further educate and provide information on the negative consequences of ObamaCare.

AFP describes itself as "a nationwide organization of citizen-leaders committed to advancing every individual’s right to economic freedom and opportunity. AFP believes reducing the size and intrusiveness of government is the best way to promote individual productivity and prosperity for all Americans."

The AFP ad competes with a national buy from the pro-Obama Organizing for Action, though both groups say the timing is coincidental.

Called "Better Coverage," the OFA ad features Stacey Lihn, who is also a young mom, and focuses on the Obamacare provision that eliminates a lifetime cap on benefits. “Thanks to Obamacare, we can now afford the care that Zoe needs. And for her, that’s a lifesaver,” she says.



Both ads are going after a key demographic in the health care debate, as this quote from a 2010 Time article explains:

Women make the primary health care decisions in two-thirds of American households. They account for 80 cents out of every dollar spent in drugstores and are likelier than men to choose the family's health insurance. Even when both parents work, wives shoulder 75% of domestic responsibilities, including making the kids' doctor appointments and getting them there on time. "Women are the main brokers of health care in the United States," says Dr. William Norcross, a family physician and faculty member at the University of California, San Diego, School of Medicine. "This has long been the case and is probably true elsewhere in the world too."

But be ready, Ohio, because the push for Ohio to expand the Medicaid program and the ad wars on Obamacare are just getting started.

Batchelder: House won't act on Medicaid bills before recess

Gongwer is reporting that the Ohio House will not act on any Medicaid overhaul bill before their recess. House Speaker Bill Batchelder said he doesn't think the House can pass the legislation before they take their summer break beginning June 30.

"My sense is that at this point in time, we cannot complete that work (before June 30) but we will continue the work,” he told reporters. “We can’t do anything before the break, in my opinion, just given the dynamics..."