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00:00:01SUPPORT FOR THE STATEWIDE
BROADCAST OF "THE STATE OF OHIO"
00:00:06COMES FROM THE LAW OFFICES OF
PORTER AND ROBERT LLP.
00:00:10ON THE WEB AT PORTER WRIGHT.COM.
AND FROM THE OHIO EDUCATION
00:00:21ASSOCIATION REPRESENT IN 120
1000 TEACHERS, SUPPORT
00:00:24PROFESSIONALS, AND HIGHER
EDUCATION FACULTY COMMITTED TO
00:00:26EVERY CHILD ONLINE.
>> THE CLOCK IS TICKING TOWARD
00:00:33THE RETURN OF LAWMAKERS TO THE
STATEHOUSE - AND TO THE DEADLINE
00:00:36FOR BIG CHANGES IN HEALTH
INSURANCE AND MEDICAID.
00:00:40TWO ADVOCATES WITH VERY
DIFFERENT VIEWS ARE HERE TO TALK
00:00:42ABOUT WHETHER THE FOCUS SHOULD
BE ON MEDICAID REFORM, MEDICAID
00:00:45EXPANSION, OR SOMETHING ELSE.
AND EMPLOYERS OF OHIO'S NATIONAL
00:00:47GUARD MEMBERS GET A CHANCE TO
SEE WHAT THEIR EMPLOYEES DO WHEN
00:00:50THEY'RE NOT WORKING FOR THEM BUT
FOR THE STATE.
00:00:52ALL THIS WEEK IN "THE STATE OF
OHIO."
00:00:58STATE LAWMAKERS ARE WINDING DOWN
THEIR SUMMER RECESS THIS MONTH.
00:01:01WHEN THEY RETURN, MEDICAID IS AT
THE TOP OF THE AGENDA.
00:01:03HOUSE SPEAKER BILL BATCHELDER
HAS SAID THAT'S MEDICAID REFORM,
00:01:07NOT EXPANSION, WHICH HE SAYS HE
OPPOSES, ALONG WITH SEVERAL
00:01:10MEMBERS OF HIS SUPERMAJORITY
CAUCUS.
00:01:13IT'S A SIMILAR STORY IN THE
SENATE, WHERE IT'S THOUGHT THAT
00:01:16MOST REPUBLICANS HAVE DEEP
CONCERNS ABOUT MEDICAID
00:01:18EXPANSION.
BUT OTHERS, INCLUDING DEMOCRATS
00:01:21IN BOTH CHAMBERS, SOCIAL
SERVICES GROUPS, HOSPITALS,
00:01:24BUSINESS ORGANIZATIONS AND GOV.
JOHN KASICH SUPPORT MEDICAID
00:01:28EXPANSION - AND A COALITION OF
THESE GROUPS HAS LAUNCHED A
00:01:32PETITION DRIVE TO PUT THE ISSUE
BEFORE VOTERS NEXT YEAR IF
00:01:35LAWMAKERS DON'T DO SOMETHING ON
IT THIS YEAR.
00:01:38HERE TO TALK ABOUT THE ISSUE OF
MEDICAID EXPANSION IS THE LEADER
00:01:41OF THAT COALITION, CALLED
HEALTHY OHIOANS WORK - HE IS JON
00:01:44ALLISON, THE FORMER LEGISLATIVE
DIRECTOR AND CHIEF OF STAFF FOR
00:01:48REPUBLICAN GOV. BOB TAFT, WHO
HAS A LONG LIST OF PRIVATE
00:01:52LOBBYING EXPERIENCE AS WELL.
AMONG THOSE WITH CONCERNS ABOUT
00:01:55MEDICAID EXPANSION IS ROBERT
ALT, THE PRESIDENT OF THE
00:01:58CONSERVATIVE THINK TANK AT THE
BUCKEYE INSTITUTE FOR PUBLIC
00:02:02POLICY SOLUTIONS, WHO IS ALSO A
VISITING SENIOR FELLOW AT THE
00:02:05HERITAGE FOUNDATION.I THINK WE
CAN START BY SAYING THAT
00:02:13SOMETHING IS LIKELY TO HAPPEN ON
MEDICAID COMING BACK TO THE
00:02:15HOUSE WITH LAWMAKERS
.
00:02:18IT SEEMS, REFORM IS A THE WAY A
LOT OF LAWMAKERS ARE TALKING
00:02:27ABOUT EXPANSION.
BUT IT IS SAFE TO SAY THAT WE
00:02:28WILL NOT MOVE BACK AND PULL BACK
ON MEDICAID DANDER IT'S.
00:02:31WE WILL NOT HAVE PEOPLE COMING
OFF OF MEDICAID ROLLS, CORRECT?
00:02:36>> I THINK THAT IS FAIR TO SAY.
>> IS THAT OK WITH YOU AND THOSE
00:02:44WITH CONCERNS ABOUT MEDICAID? >>
I THINK EVERYONE ON EVERY SIDE
00:02:48OF THE AISLE OF BREEDS -- AGREES
THAT IT IS NOT WORKING ALREADY.
00:02:56MEDICAID IS A BROKEN SYSTEM THAT
PROVIDES POOR RESULTS FOR PEOPLE
00:02:59WHO ARE RECIPIENTS OF THAT.
I THINK IT IS RIGHT FOR THE
00:03:03LEGISLATURE TO LOOK AT WAYS THAT
MEDICAID COULD BE FIXED, RATHER
00:03:06THAN GROWING THE PROGRAM.
>> AND I WANT YOU TO ADDRESS
00:03:09SOME OF THE CONCERNS THAT I'M
SURE ROBERT WILL BRING UP.
00:03:12MEDICAID IS A BROKEN SYSTEM.
>> IT IS NOT A PERFECT SYSTEM,
00:03:20BUT PEOPLE NEED TO TAKE INTO
ACCOUNT THE SIGNIFICANT CHANGES
00:03:22THAT HAVE HAPPENED WITH THIS
PROGRAM, REALLY, OVER THE LAST
00:03:27THREE OR FOUR YEARS.
OVER THE LAST I ANY HIM,
00:03:29MEDICAID HAS SPENT -- OVER THE
LAST BIENNIUM, MEDICAID HAS
00:03:33SPENT OVER BILLION DOLLARS.
IT IS ALREADY MANAGED BY PRIVATE
00:03:42SECTOR MANAGED CARE
ORGANIZATIONS AND SIGNIFICANT
00:03:43CHANGES HAVE HAPPENED WITH THAT
PROGRAM.
00:03:44THEY HAVE A NEW DID -- DATA
SYSTEM OVER THERE IN WHICH THEY
00:03:49CAN MAKE DECISIONS THAT HAD NOT
BEEN THERE BEFORE.
00:03:52A LOT OF FOLKS AS WE GOT INTO
THIS DEBATE WERE THINKING ABOUT
00:03:57THE MEDICARE -- MEDICAID SYSTEM
THAT WAS THE FEE FOR SERVICE
00:04:03SYSTEM, WHICH WAS OUT.
IT WAS OUT-OF-CONTROL WHEN I WAS
00:04:06IN THE GOVERNOR'S OFFICE.
BUT IT IS BETTER.
00:04:08IS IT PERFECT?
NO.
00:04:10IS THERE ROOM FOR IMPROVEMENT?
ABSOLUTELY.
00:04:14>> ARE YOU TREATING MEDICAID AS
A MONOLITH THAT IS NOT CHANGING
00:04:21FROM STATE TO STATE?
OR ARE YOU LOOKING AT HOW OHIO
00:04:25AND OTHER STATES ARE DEALING
WITH IT AS REGARDS MEDICAID
00:04:29EXPANSION?
>> WE ARE LOOKING AT PROPOSALS
00:04:33THAT ARE BEING CONSIDERED THOSE
IN OHIO AND IN MICHIGAN.
00:04:35WE ARE LOOKING AT SIMILAR
SOLUTIONS.
00:04:38THE PROBLEM THERE, WHAT WE FOUND
IS A LOT OF LEGISLATORS, WHEN
00:04:44THEY ARE LOOKING AT EXPANDING
MEDICAID, THEY HAVE CONCERNS.
00:04:45I FIND YOUR ORGANIZATION
INTERESTING.
00:04:51IT IS HEALTHY OHIOANS WORK HERE
IT -- WORK.
00:04:55PART OF THE PROBLEM WE ARE
CONFRONTING IS IF WE EXPAND
00:05:00MEDICAID, WE ARE NOT ALLOWED TO
PUT WORK REQUIREMENTS ON THEIR
00:05:03PEERMAN STUDIES SHOW THAT IF WE
PUT MORE PEOPLE ON MEDICAID, IT
00:05:05WILL ENCOURAGE THEM NOT TO WORK.
COULD WE GET A WAIVER FROM THE
00:05:13FEDERAL GOVERNMENT TO ALLOW US
TO DO THAT?
00:05:14AND THE FEDERAL GOVERNMENT HAS
ESSENTIALLY SAID NO.
00:05:18ANYTHING THAT THREATENS
ELIGIBILITY, INCLUDING WORK
00:05:23REQUIREMENTS, CO-PAYS, ALL SORTS
OF THINGS THAT THE LEGISLATORS
00:05:28ARE LOOKING AT ARE OFF THE
TABLE.
00:05:28YOU TAKE A BROKEN SYSTEM AND YOU
ENCOURAGE PEOPLE NOT TO WORK.
00:05:33APPARENTLY, HEALTHY OHIOANS WILL
NOT WORK.
00:05:37AND THEN WE HAVE TO ASK WHETHER
THEY WILL BE HEALTHY.
00:05:40IN STUDY AFTER STUDY SHOWS WE
CAN SEE SPENDING FOR MEDICAID,
00:05:44BUT WE DO NOT ACTUALLY SEE
IMPROVEMENTS IN HEALTH.
00:05:45AND THAT IS WHETHER IT IS A
BLIND DRAW, AS THEY DID IN
00:05:51OREGON, OR IF YOU ARE LOOKING AT
HUNDREDS OF THOUSANDS OF
00:05:54SURGERIES WHERE PEOPLE ARE
LOOKING AT POOR RESULTS IF THEY
00:05:57HAD MEDICAID RATHER THAN NO
INSURANCE AT ALL.
00:06:00IT IS NOT JUST THAT WE ARE
TINKERING WITH THE PROGRAM, BUT
00:06:04WE HAVE A PROGRAM THAT IS NOT
ACTUALLY PERFORMING.
00:06:08>> IF I COULD JUST SAY, TO THE
ISSUE OF CO-PAYS, I BELIEVE THAT
00:06:11IS ON THE TABLE AND HAS BEEN FOR
SOME TIME.
00:06:12IF EXPANSION DOES HAPPEN, THAT
WILL BE ON THE TABLE.
00:06:18AND THE ISSUE OF WORKFORCE
REQUIREMENTS, OR WORK
00:06:21REQUIREMENTS, I THINK ROBERT IS
EXACTLY RIGHT.
00:06:25ALL OF THE SIGNALS ARE FROM THE
FEDERAL GOVERNMENT THAT IT IS A
00:06:27STATE PARTNERSHIP, A HARD AND
FAST WORK REQUIREMENT IS NOT
00:06:31SOMETHING THAT THE FEDERAL
GOVERNMENT CAN LIVE WITH.
00:06:34AROUND THIS DISCUSSION, WE WILL
SEE HOW THIS PLAYS OUT WHEN THE
00:06:41LEGISLATURE IS BACK THIS FALL.
THERE IS REAL TALK ABOUT
00:06:48LINKAGES TO WORKFORCE, AND
INTEGRATING THAT INTO MANAGED
00:06:50CARE.
INTO THE MANAGED CARE THAT WE
00:06:55HAVE, SO WE DON'T END UP, AS
ROBERT IS SUGGESTING, THAT WOULD
00:07:00BE A VERY PERVERSE CONSEQUENCE
IF THE PROGRAM WAS ENCOURAGING
00:07:04PEOPLE TO JUST GIVE UP AND LIVE
OFF OF GOVERNMENT ENTITLEMENT
00:07:07PROGRAMS.
I THINK THERE'S POTENTIAL THERE.
00:07:12IN MAY NOT BE A HARD AND FAST
WORK REQUIREMENT, BUT THERE IS A
00:07:16WAY TO CREATE LINKAGES TO THE
MANY, MANY WORKFORCE PROGRAMS
00:07:19THAT WE HAVE AT OUR STATE AND
FEDERALLY FUNDED.
00:07:21AND THEN CREATE PATHWAYS TO GET
THESE FOLKS UP AND OUT OF
00:07:25POVERTY WITH THE ABILITY TO HAVE
HEALTH CARE.
00:07:31>> I WOULD SUGGEST THAT THE
BETTER WAY TO DO THAT IS TO NOT
00:07:32LOCK OURSELVES INTO A PROGRAM
THAT PROHIBITS US FROM PUTTING
00:07:36IN A REQUIREMENT HERE IT -- A
REQUIREMENT.
00:07:39WE CAN LOOK AT OTHER STATES AND
SEE WHETHER OR NOT THEY
00:07:43EXPANDED.
THE NATIONAL BUREAU OF ECONOMIC
00:07:48RESEARCH, WHICH IS NONPARTISAN,
TOOK A LOOK AT THE NUMBERS AND
00:07:52SAW THAT IT DROVE PEOPLE WHO
WERE WORKING COMPLETELY OFF THE
00:07:53WORKFORCE.
NATIONWIDE, ONE MILLION PEOPLE
00:07:58ACCORDING TO THEIR ESTIMATES,
WOULD DROP OFF THE WORKFORCE.
00:08:01I AGREE THAT IS A PERVERSE
INCENTIVE.
00:08:05WHY ARE WE TRYING TO DO
SOMETHING THAT WOULD HAVE THAT
00:08:07KIND OF OUTCOME?
@BUCKEYE, WE HAVE BEEN LOOKING
00:08:10FOR SOLUTIONS.
FOR INSTANCE, IS THERE A WAY FOR
00:08:15THE STATE TO RUN ITS OWN
PROGRAMS, AND FOR THE STATE TO
00:08:18DO SO IN A WAY THAT WOULD
ACTUALLY PUT IN A WORKFORCE
00:08:21REQUIREMENT?
WE SAW THAT THOSE COULD WORK.
00:08:24IT WOULD TRANSITION PEOPLE INTO
MORE PRODUCTIVE.
00:08:27-- MORE PRODUCTIVE MEMBERS OF
SOCIETY.
00:08:31WE WOULD RATHER SEE
CONVERSATIONS LIKE THAT, RATHER
00:08:36THAN LOCKING OURSELVES INTO A
FAILING PROGRAM THAT HAS, AS
00:08:42YOU PUT IT, PERVERSE INCENTIVES.
>> I WOULD BE CAREFUL AND MAKE
00:08:45SURE THAT WE ARE LOOKING AT
APPLES TO APPLES.
00:08:46YOU MENTIONED THE OREGON STUDY,
THE TENNESSEE STUDY, DIFFERENT
00:08:52PROGRAMS, DIFFERENT POPULATIONS,
DIFFERENT RULES, DIFFERENT LAWS.
00:08:54YOU WOULD HAVE TO LOOK AND SEE
WHERE FOLKS HAVE DONE THINGS
00:08:57SUCCESSFULLY AND WHERE THEY HAVE
MADE MISTAKES, ABSOLUTELY, BUT
00:09:02TO AUTOMATICALLY ASSUME THAT OUR
PROGRAM IS THE SAME AS TENNESSEE
00:09:04OR OREGON IS THE WRONG PATHWAY.
A PIECE CAME OUT OF OHIO STATE
00:09:13THAT REALLY POINTED OUT THAT
THESE ARE APPLES TO PINEAPPLES
00:09:17COMPARISONS.
HAVING SAID THAT, I RESPECT --
00:09:25HE HAS DONE A GREAT JOB IN
TAKING THIS ORGANIZATION TO A
00:09:27NEW LEVEL.
BUT I THINK WE NEED TO BE
00:09:29CAREFUL TO MAKE SURE THAT WE ARE
NOT JUST DISMISSING THIS BECAUSE
00:09:34SOME OTHER STATES MADE BAD
CHOICES WITH THE MEDICAID
00:09:37PROGRAM.
>> AND EVERYBODY HAS STUDIES
00:09:39THAT SHOW DIFFERENT THINGS.
THAT SEEMS TO BE THE RESOUNDING
00:09:43THEME THROUGHOUT ANY DISCUSSION
ABOUT A POLICY MATTER.
00:09:45ONE ARGUMENT I HAVE HEARD FROM
YOUR SITE -- YOUR SIDE, ROBERT,
00:09:51IS HOW MANY PEOPLE WOULD BE
COVERED UNDER MEDICAID, THAT THE
00:09:54NUMBERS MIGHT NOT BE 275,000
PEOPLE COVERED UNDER EXPANSION,
00:09:59BUT MUCH BIGGER, 500,000,
900,000.
00:10:01AND JOHN, ARE WE CERTAIN THAT
275,000 PEOPLE WOULD BE THE
00:10:06AMOUNT THAT ARE COVERED BY
MEDICAID EXPANSION?
00:10:10>> ARE WE CERTAIN ABOUT ANYTHING
THAT IS GOING TO HAPPEN ONCE THE
00:10:15AFFORDABLE CARE ACT IS
IMPLEMENTED?
00:10:16NO.
THOSE ARE THE NUMBERS THAT HAVE
00:10:19BEEN GENERATED BY THE FOLKS OF
THE KASICH ADMINISTRATION.
00:10:23THE 275,000 NUMBER PERTAINED TO
THE STATE BUDGET AND WAS IN THAT
00:10:32CONTEXT, AND WAS DONE BY THE
PEOPLE WHO RUN THIS PROGRAM, THE
00:10:35STATE PEOPLE WHO RUN THIS
PROGRAM WHO DID THE TRENDS.
00:10:40THEY ARE PROBABLY NOT PERFECT IN
THEIR PROJECTIONS, BUT DID THE
00:10:43BEST THEY COULD WITH THEIR DATA.
>> ARE YOU CONFIDENT IN THOSE
00:10:47NUMBERS?
>> I DON'T THINK HE KASICH
00:10:52ADMINISTRATION IS CONFIDENT IN
THOSE NUMBERS.
00:10:53I RECENTLY HEARD 500,000 IN A
SPEECH.
00:10:59I WOULD THINK HE WOULD BE IN A
POSITION TO KNOW.
00:11:02>> THE 500,000 COULD BE -- THE
275 THOUSAND WAS FOR THE FIRST
00:11:07TWO YEARS OF EXPANSION.
CLEARLY, AS WE HAVE BEEN IN THIS
00:11:12DEBATE, WE KNOW THAT IS NOT THE
CEILING.
00:11:14THE NUMBER WOULD BE HIGHER THAN
THAT BEYOND THOSE TWO YEARS.
00:11:15I SUSPECT THAT IS WHY JOHN SAID
THAT.
00:11:21>> UNFORTUNATELY, THEY DID NOT
USE THEIR LARGER NUMBERS IN THE
00:11:27PROJECTIONS ON COSTS.
IF THEY ARE PROJECTING IT WILL
00:11:29BE HALF $1 MILLION, THAT WILL
GREATLY INFLATE THE COST.
00:11:32-- WILL BE 500 THOUSAND DOLLARS,
THAT WILL GREATLY INFLATE THE
00:11:38COST.
ONE OF THE BIG FAILINGS IS THAT
00:11:43A NUMBER OF PRIMARY CARE
PHYSICIANS SIMPLY WILL NOT TAKE
00:11:46MEDICAID PATIENTS.
IN OHIO, 28% OF DOCTORS WILL NOT
00:11:51TAKE NEW MEDICAID PATIENTS.
THIS DRIVES MORE PEOPLE TO THE
00:11:54EMERGENCY ROOMS, WHICH ARE
ALREADY OVERBURDENED WITH
00:11:56MEDICAID PATIENTS.
YET WE ARE GOING TO ADD MORE
00:12:00PEOPLE TO THE ROLES?
WHY ARE WE NOT LOOKING AT BETTER
00:12:03SOLUTIONS THAT COULD, PERHAPS,
PROVIDE PRIVATE INSURANCE
00:12:07THROUGH A STATE PLAN, OR
SOMETHING WHERE YOU ARE NOT
00:12:11OVERBURDENING AN ALREADY
OVERBURDENED SYSTEM?
00:12:12>> I WOULD SAY, CLEARLY, I
BELIEVE WE HAVE A REFORM AGENDA
00:12:20AND WE HAVE SPECIFICS ABOUT WHAT
THE LEGISLATURE IS CONTEMPLATING
00:12:24WITH REFORM.
WE WILL SEE PROPOSALS ON
00:12:25BUILDING THAT CAPACITY TO MAKE
SURE THERE IS ENOUGH PRIMARY AND
00:12:27PREVENTATIVE CARE TO MAKE SURE
THERE ARE OPTIONS FOR THESE
00:12:35FOLKS.
ROBERT MAKES A FAIR STATEMENT.
00:12:37WE HAVE A LONG WAY TO GO.
THE ACA ACTUALLY INCLUDED A
00:12:40PROVISION THAT GIVES PRIMARY
CARE DOCTORS A HIGHER
00:12:46REIMBURSEMENT RATE FOR A SHORT
TIMEFRAME TO INCENTIVIZE THEM TO
00:12:48SEE THESE PATIENTS.
I DO NOT KNOW WHETHER THAT IS A
00:12:51LONG-TERM SOLUTION OR NOT.
I THINK WE WILL SEE SOME
00:12:55REFORMS.
THERE IS A CAPACITY ISSUE AS THE
00:13:01LEGISLATURE LOOKS AT THIS.
I SUSPECT THEY WILL NOT BE THE
00:13:03END ALL TO BE ALL -- THE BE ALL
TO END ALL AND I THINK THEY WILL
00:13:10FIX THAT.
>> I WILL ASK YOU, ROBERT, ABOUT
00:13:18THE EXPANSION YOU MENTIONED.
AND YOU MENTION PEOPLE GOING TO
00:13:23HOSPITALS.
A LOT OF HOSPITALS SAY THEY ARE
00:13:24THREATENED IF THE MEDICAID
EXPANSION DOES NOT GO THROUGH.
00:13:26RURAL HOSPITALS AND URBAN
HOSPITALS ALIKE.
00:13:30HOW DO YOU ACHIEVE SUPPORTING
THOSE HOSPITALS WITHOUT MEDICAID
00:13:35EXPANSION?
>> THERE ARE A COUPLE OF THINGS.
00:13:38ONE, YOU NEED TO TAKE SOME OF
THESE PROTESTATIONS WITH A GRAIN
00:13:42OF SALT.
MOST OF THE HOSPITALS IN THIS
00:13:45STATE GET LESS THAN ONE PERCENT
OF THE REVENUES FROM CHARITY
00:13:49CARRIER REIMBURSEMENT.
THE CLAIM THAT WE WILL BE
00:13:53SHUTTERING THE CLEVELAND CLINIC
IS A BIT OVERWROUGHT.
00:13:54YOU NEED TO LOOK AT THOSE SORTS
OF QUESTIONS.
00:13:58THE OTHER QUESTION WITH REGARD
TO THIS IS, AGAIN, IS THERE
00:14:04INTENTIONALLY A BETTER WAY?
RIGHT NOW, PART OF THE PROBLEM
00:14:12THEY ARE FACING IS THAT THE
FEDERAL GOVERNMENT IS CUTTING
00:14:13FUNDING FOR AN COMPETENT --
UNCOMPENSATED CARE.
00:14:17WHAT THEY DO NOT ACTUALLY TELL
YOU IS IF THEY EXPAND MEDICAID,
00:14:22WHAT WILL THE FEDERAL GOVERNMENT
DO?
00:14:23THEY ARE REQUIRED BY FEDERAL LAW
TO CUT OUR UNCOMPENSATED FUNDING
00:14:29EVEN MORE.
THE MORE PEOPLE WHO ARE INSURED
00:14:31IN THE STATE, THE MORE THEY HAVE
TO ACTUALLY CUT THE FUNDING
00:14:33UNDER OBAMACARE.
THE HOSPITALS WILL GET EVEN LESS
00:14:37UNCOMPENSATED CARE FROM THE
GOVERNMENT.
00:14:40>> BUT YOU SAID THEY ARE ONLY
GETTING A LITTLE BIT OF
00:14:43UNCOMPENSATED CARE COVERAGE NOW.
>> IT WILL BE CUT EVEN FURTHER.
00:14:47IF THEY ARE CONCERNED, THEY
SHOULD BE CONCERNED EVEN MORRIS
00:14:51MEDICAID EXPANDS.
WHAT WE HAVE SEEN IN STATE AFTER
00:14:53STATE UNDER OPTIONAL PROGRAMS IS
THEY WENT AHEAD AND DID IT
00:15:00THINKING THEIR UNCOMPENSATED
CARE COSTS WOULD GO DOWN.
00:15:03BUT IN STATE AFTER STATE WHAT
ACTUALLY HAPPENED WAS, UNCOMMON
00:15:06-- UNCOMPENSATED CARE COSTS WENT
UP, EVEN AFTER EXPANDING THE
00:15:11POOL OF APPLICANTS.
>> THAT IS NOT WHAT WE ARE
00:15:13HEARING FROM HOSPITALS ACROSS
THE STATE.
00:15:14THEIR CONCERN IS THAT THE DEAL
THAT WAS MADE UNDER THE
00:15:20AFFORDABLE CARE ACT AS IT WAS
PASSED IN CONGRESS IS THAT
00:15:22UNCOMPENSATED CARE WOULD
CONTINUE TO GO DOWN.
00:15:24AND THE PARTIAL OFFSET IS
EXPOSED -- IS ASSOCIATED WITH
00:15:27EXPANSION.
AND THERE WILL BE A GAP IN
00:15:31EXPANSION IN THE STATE.
AND THE PROBLEM WILL NOT BE
00:15:35EQUAL ACROSS ALL HOSPITAL
SYSTEMS, BUT CERTAINLY, WHEN I
00:15:38THINK OUT THE SMALLER HOSPITALS,
IN THE COUNTY WHERE I GREW UP
00:15:42ESPECIALLY, I HAVE NOT SEEN THE
NUMBERS.
00:15:49BUT I SUSPECT RURAL HOSPITALS
WILL BE IN MORE JEOPARDY.
00:15:51THERE HAS BEEN THOUGHT ABOUT
USING STATE FUNDS, SAYING NO TO
00:15:56EXPANSION, NO TO FEDERAL
DOLLARS, USING STATE FUNDS TO
00:16:00TAILOR SOMETHING AND CONTROL
SOMETHING THAT IN THEORY IS
00:16:04CONTROLLABLE IN THE LONG TERM.
I JUST HAVE TO WONDER WHY THAT
00:16:10MAKES SENSE.
AGAIN, YOUR MONEY, YOUR CONTROL.
00:16:17BUT WHEN OHIO TAXPAYERS AND
BUSINESSES ARE ON THE HOOK TO
00:16:21PAY FEDERAL FEES AND TAXES FOR
THE AFFORDABLE CARE ACT, THE
00:16:28THOUGHT THAT WE WOULD LEAVE
THOSE DOLLARS ON THE TABLE
00:16:29INSTEAD AND USE STATE TAX
DOLLARS, I DON'T KNOW HOW I
00:16:39COULD SELL THAT TO THE GENERAL
ASSEMBLY.
00:16:42>> I APPRECIATE YOU MAKING THAT
ARGUMENT.
00:16:43IT IS IS A FALLACY THAT I THINK
NEEDS TO GET OUT THERE, THE IDEA
00:16:46THAT WE ARE LEAVING FEDERAL
MONEY ON THE TABLE OR WE WILL GO
00:16:51SOMEPLACE ELSE.
WHEN GOVERNOR KASICH GOT ELECT
00:16:54DID, THERE WAS A BROUHAHA ABOUT
THE HIGH-SPEED RAIL.
00:16:56OHIO HAD GOTTEN THIS POT OF
MONEY FOR HIGH-SPEED RAIL, AND
00:17:01THE GOVERNOR SAID NO.
HE TOLD THEM TO GO AHEAD AND
00:17:04SEND IT BACK TO THE TREASURY.
BUT THE OBAMA ADMINISTRATION WAS
00:17:07NOT ABOUT TO DO THAT HERE DID
HAD APPROPRIATED THOSE FUNDS.
00:17:09THEY ACTUALLY EXISTED.
IT WAS A BUCKET OF MONEY THAT
00:17:17INSTEAD OF GOING TO OHIO WENT TO
CALIFORNIA.
00:17:19IN THAT CASE, WE CAN SAY WE LEFT
MONEY ON THE TABLE.
00:17:23THAT MONEY WENT SOMEPLACE ELSE.
IN THE CASE OF MEDICAID, IT IS A
00:17:27MATCHING FUND PROGRAM.
THERE ARE NO FUNDS LEFT ON THE
00:17:28TABLE.
IF WE DO NOT EXPAND MEDICAID,
00:17:31THOSE FUNDS NEVER IT'S MEANT --
OR QUITE FRANKLY, THEY NEVER GET
00:17:37BORROWED FROM CHINA.
>> BUT THE PROBLEM FOR THOSE WHO
00:17:42SUPPORT MEDICAID EXPANSION, YOU
STILL HAVE A HUGE NUMBER OF
00:17:44PEOPLE WHO ARE POOR AND CANNOT
AFFORD HEALTH INSURANCE WHO
00:17:47WOULD BENEFIT FROM MEDICAID
EXPANSION.
00:17:48>> LET'S TALK ABOUT THIS AGAIN.
WHO IS THIS POPULATION
00:17:55PREDOMINANTLY?
WE ARE NOT TALKING ABOUT AGED,
00:18:00BLIND, DISABLED, PREGNANT WOMEN,
CHILDREN.
00:18:03FOR THE MOST PART WE ARE NOT
TALKING ABOUT FAMILIES WITH
00:18:07CHILDREN.
WE ARE MOSTLY TALKING ABOUT
00:18:08ABLE-BODIED MEN AND WOMEN,
PREDOMINATELY MEN, WHO ARE ABLE
00:18:12TO WORK.
AND THIS WILL DRIVE INDIVIDUALS
00:18:14OUT OF THE WORKFORCE.
IF WE ARE GOING TO PROVIDE
00:18:18COVERAGE FOR THOSE INDIVIDUALS,
IT IS ESSENTIAL THAT WE LOOK AT
00:18:21THE NEEDS OF THIS GROUP AND MAKE
SURE WE ARE NOT JUST GIVING THEM
00:18:24A HAND UP, BUT HELPING THEM BACK
INTO THE WORKFORCE TO BE MORE
00:18:29SELF-SUFFICIENT.
I THINK WE CAN DO THAT BETTER
00:18:31THROUGH OUR OWN PROGRAM THAN
THROUGH A FAILED FEDERAL
00:18:37PROGRAM.
>> RESPECTFULLY, I THINK TO
00:18:38PAINT THIS AS A SOLUTION, WHICH
WOULD ESSENTIALLY INCENTIVIZE A
00:18:43BUNCH OF UNDEREMPLOYED SINGLE
ADULTS TO GIVE UP ON TRYING TO
00:18:50WORK AND EARN A LIVING GOES A
LITTLE TOO FAR.
00:18:54THE FLIPSIDE OF THAT IS WE HAVE
UNEMPLOYED SINGLE ADULTS WHO
00:18:59WOULD BENEFIT FROM THIS.
MANY OF WHICH HAVE HEALTH ISSUES
00:19:04THAT THEY ARE DEALING WITH, AND
THIS IS A WAY TO GET THOSE
00:19:07THINGS TO A MORE STABLE PLACE.
AND HELP THEM TO BE IN A
00:19:11POSITION WHERE THEIR LIFE IS
MORE STABLE AND THEY ARE
00:19:14ACTUALLY ABLE TO AVAIL
THEMSELVES OF THE WORKFORCE
00:19:18LINKAGES THAT I THINK WE WILL
SEE COMING ALONG WITH THIS.
00:19:22AND THEY WILL BE IN A BETTER
POSITION TO WORK AND MOVE THEIR
00:19:25LIVES FORWARD.
>> UNFORTUNATELY, MY LAST
00:19:27QUESTION HERE.
TO JOHN, WHAT WILL YOU MAKE YOUR
00:19:31DECISION ON WITH REGARD TO THE
BALLOT?
00:19:34I KNOW YOU ARE WAITING FOR THE
LEGISLATURE TO COME BACK AND DO
00:19:37WHATEVER THEY ARE YOU WAITING ON
THEM TO DO THAT MAKES YOU SAY,
00:19:40WE ARE GOING TO GO TO BALLOT?
DOES IT HAVE TO BE EXPANSION OR
00:19:45HE GOES TO BALLOT?
>> WE ARE HOPING THE LEGISLATURE
00:19:49WILL AUTHORIZE EXPANSION BEFORE
THE END OF THIS CALENDAR YEAR.
00:19:52>> END OF THE LEGISLATURE DOES
NOT, OR THE GOVERNOR DOES NOT DO
00:19:55SOMETHING WITH AN EXECUTIVE
ORDER, YOU'RE GOING TO A BALLOT
00:19:57NEXT YEAR.
>> THAT IS THE PLAN.
00:19:59>> HOW FAR DOES THAT SET YOU
BACK, BECAUSE 2014 IS ALREADY
00:20:04INTO THE FIRST YEAR THAT THE
GOVERNMENT FEDERAL HE WOULD
00:20:08REIMBURSE THE STATE OF OHIO.
YOU ARE ALREADY BEHIND IN
00:20:13GETTING THAT $13 BILLION BACK
OVER SEVEN YEARS.
00:20:17>> A YEAR OF THE FUNDING IS LOST
IF WE HAVE TO WAIT FOR VOTER
00:20:19APPROVAL LATE 2014.
CORRECT.
00:20:23>> BUT YOU WILL STILL DO IT IF
MEDICAID EXPANSION DOES NOT
00:20:26HAPPEN?
>> THERE ARE NOT MANY OTHER
00:20:29OPTIONS ON THE TABLE.
CLEARLY, WITH WHAT WE HAVE
00:20:32PROPOSED, -- OF COURSE, IT IS AN
INITIATED STATUTE.
00:20:35IN GATHERING THE SIGNATURES THAT
WE NEED, THE ISSUE GETS PLACED
00:20:41BACK INTO THE LEGISLATURE FOR
THE FIRST FOUR MONTHS OF NEXT
00:20:43YEAR.
AGAIN, OUR NUMBER ONE PRIORITY
00:20:47IS GETTING THE LEGISLATURE TO
AUTHORIZE THIS.
00:20:50THIS IS NOT IDEAL.
IT IS NOT A GREAT SOLUTION TO GO
00:20:53TO THE BALLOT.
BUT WE HAVE TO PUT THAT OPTION
00:20:57ON THE TABLE.
>> AND I KNOW BUCKEYE IS NOT A
00:20:59POLITICAL ORGANIZATION, BUT
ROBERT, DO YOU EXPECT THERE
00:21:01WOULD BE STIFF OPPOSITION IF IT
GOES TO THE BALLOT?
00:21:04>> I WOULD THINK SO.
THE HOSPITALS, WHICH ARE SEEKING
00:21:10TO PROFIT FROM THIS, WOULD HAVE
TIME TO PUT ON THE BALLOT.
00:21:18BUT IT IS DIFFICULT TO SEE HOW
THOSE WHO ARE STUCK FOOTING THE
00:21:20BILL WOULD SUPPORT THIS.
>> AND CONGRESS MAY COME OUT IN
00:21:25FAVOR OF THIS AS WELL.
IT IS BUSINESS GROUPS AS WELL AS
00:21:28HOSPITAL GROUPS AS WELL AS
OTHERS.
00:21:31IT IS A BIG COALITION.
IN A WAY, STRANGE ALLIANCES,
00:21:34PEOPLE WHO WERE NOT NECESSARILY
SUPPORTIVE OF GOVERNOR KASICH
00:21:38ARE BEHIND HIM ON THIS.
>> IT IS NOT NECESSARILY THE
00:21:43COALITION IS AS MONOLITHIC AS
SUPPORTERS WOULD HAVE YOU
00:21:50BELIEVE.
HOSPITALS ARE CERTAINLY A PRIME
00:21:53MOVER ON THIS.
AND HOSPITAL ASSOCIATION WILL
00:21:55SEE SIGNIFICANT GAIN ON THIS.
>> JOHN ALLISON, ROBERT ALT,
00:22:02THANK YOU FOR BEING HERE.
>> THERE ARE AROUND 17,000
00:22:07OHIOANS WHO ARE SERVING IN THE
OHIO ARMY AND AIR NATIONAL
00:22:10GUARD.
THE STATE HAS THE LARGEST ARMY
00:22:12NATIONAL GUARD IN THE NATION.
AND THE STATE WAS THE FIRST TO
00:22:14HAVE A CERTIFIED HOMELAND
RESPONSE FORCE, WHICH CAN BE
00:22:17DISPATCHED TO ANY NATURAL,
CHEMICAL, BIOLOGICAL, NUCLEAR OR
00:22:19OTHER DISASTER WITHIN THIS
REGION BY THE FEDERAL EMERGENCY
00:22:23MANAGEMENT AGENCY.
WHILE SOME OF THOSE SOLDIERS AND
00:22:25AIRMEN ARE STUDENTS, MOST OF
THEM ARE FULL-TIME WORKERS FOR
00:22:28EMPLOYERS ACROSS OHIO WHEN THEY
ARE NOT IN UNIFORM.
00:22:31AND THE OHIO NATIONAL GUARD IS
WELL AWARE OF THE IMPORTANCE OF
00:22:34EMPLOYERS TO ITS CAUSE.
THE GUARD OFFERED EMPLOYERS TO
00:22:40THE AIR AND ARMY NATIONAL GUARD
BASE AT RICKENBACKER SOUTH OF
00:22:45COLUMBUS A FEW WEEKS AGO THE
CHANCE TO GET A CLOSE LOOK AT
00:22:48THEIR EMPLOYEES' OTHER JOBS, AND
I WAS INVITED TO JOIN THEM.
00:22:51BRIGADIER GENERAL MARK STEPHENS
SAYS THAT INCLUDES HELICOPTERS
00:22:54AND OTHER AIRCRAFT, INCLUDING
THE BIG KC-135 STRATOTANKER
00:22:57REFUELING PLANE, TRUCKS AND
BASIC FIELD EQUIPMENT, AND EVEN
00:23:00WEAPONS - VIA A SIMULATOR. X YOU
CAN SEE THE EQUIPMENT THAT WE
00:23:09HAVE -- >> YOU CAN SEE THE
EQUIPMENT THAT WE HAVE HERE,
00:23:13THEY CAN BE USED FOR FEDERAL AND
STATE MISSIONS.
00:23:15>> AND YOU ALSO GET A LOOK AT
SOME OF THE WEAPONS, THE
00:23:17VEHICLES.
>> AND THE PERSONAL EFFECTS THAT
00:23:20FOLKS USE.
JUST ABOUT EVERYTHING THAT WE
00:23:24HAVE.
WE WANT TO GIVE PEOPLE A GOOD
00:23:25FEEL FOR WHAT FOLKS ARE DOING.
>> AND EMPLOYERS WHO ATTEND SAY
00:23:33THEY APPRECIATE THE OPPORTUNITY
TO LEARN ABOUT WHAT THEIR
00:23:35EMPLOYEES DO WHILE IN UNIFORM -
AND TO FIND OUT ABOUT RESOURCES
00:23:38AVAILABLE TO THEM WHEN THOSE
EMPLOYEES ARE SUDDENLY DEPLOYED
00:23:40AND UNAVAILABLE.
ARMY VETERAN DAN HENDERSON OWNS
00:23:42HENDERSON CONTRACTING IN
COLUMBUS - AMONG HIS 15
00:23:44EMPLOYEES ARE TWO GUARD MEMBERS
AND SEVERAL VETERANS.>> IT IS
00:23:50NOT REALLY A CHALLENGE BECAUSE
THERE IS A SINGLENESS OF
00:23:52PURPOSE.
THERE IS A GOOD REASON FOR IT,
00:23:56TO KEEP US SAFE BACK HERE.
PLUS, I'M A VETERAN, SO I WAS IN
00:24:01THE MILITARY.
I CAN UNDERSTAND WHAT A THAT GO
00:24:02THROUGH -- WHAT A VETERAN GOES
THROUGH WHEN THE SHOE IS ON THE
00:24:07OTHER FOOT GOOD WE PREPARE A
PLACE FOR THEM TO GO BACK TO --
00:24:13TO COME BACK TO.
>> NAVY VETERAN TONY KONECNY IS
00:24:17WITH FIRST COMMAND FINANCIAL
PLANNING, WHICH HAS A FOCUS ON
00:24:20MILITARY FAMILIES - AND HE KNOWS
HOW HARD DEPLOYMENTS CAN BE ON
00:24:22EMPLOYEES AND EMPLOYERS.>> THAT
IS ALWAYS THE HAZARD ASSOCIATED
00:24:27WITH IT, BUT YOU ALSO HAVE TO
LOOK AT THE OTHER SIDE.
00:24:31THERE ARE SOME HIGHLY TRAINED
PEOPLE DOING SOME VERY IMPORTANT
00:24:33TASKS.
THEY'RE OWING TO BE GONE FOR
00:24:34SOME TIME, BUT THEY ARE GOOD
WORKERS AND CAN DO A GOOD JOB
00:24:40RICK
>> THE OHIO NATIONAL GUARD
00:24:42INVITES EMPLOYERS FROM AROUND
OHIO TO THE RICKENBACKER AIR
00:24:44NATIONAL GUARD BASE SEVERAL
TIMES A YEAR - NOT ONLY DO THEY
00:24:46SEE, TOUCH, AND TOUR THE
EQUIPMENT AND AIRCRAFT, BUT THEY
00:24:49ALSO GET TO EAT LUNCH - THE
CLASSIC MRE, "MEAL READY TO EAT"
00:24:51AND THE REVIEWS ARE THAT THEY'RE
NOT TOO BAD.
00:24:54AND THAT'S IT FOR THIS WEEK.
FOR MY COLLEAGUES AT OHIO PUBLIC
00:24:57RADIO AND TELEVISION, THANKS FOR
WATCHING.
00:24:59IF YOU'D LIKE TO ASK QUESTIONS,
MAKE COMMENTS, OR WATCH THIS
00:25:02WEEK'S SHOW OR EARLIER EPISODES,
PLEASE VISIT OUR WEBSITE AT
00:25:04STATENEWS.ORG.
YOU CAN ALSO CHECK US OUT ON
00:25:07FACEBOOK, AND YOU CAN FOLLOW JO
INGLES, ANDY CHOW AND ME ON
00:25:10TWITTER.
AND PLEASE JOIN US AGAIN NEXT
00:25:12TIME FOR "THE STATE OF OHIO."
CAPTIONED BY THE
00:25:21NATIONAL CAPTIONING INSTITUTE
--WWW.NCICAP.ORG--
00:25:22"FINER WITH AGE
>> SUPPORT FOR THE STATEWIDE
00:26:20BROADCAST OF "THE STATE OF OHIO"
COMES FROM THE OFF -- LAW
00:26:23OFFICES OF PORTER WRIGHT MORRIS
LLP, HELPING INDIVIDUALS SOLVE
00:26:29COMPLEX AND LEGAL PROBLEMS IN
OHIO AND ACROSS THE COUNTRY AND
00:26:34AROUND THE WORLD.
AND FROM THE OHIO EDUCATION
00:26:36ASSOCIATION REPRESENTING 121
THOUSAND TEACHERS, SUPPORT
00:26:41PROFESSIONALS, AND HIGHER
EDUCATION FACULTY COMMITTED TO
00:26:43THE SUCCESS OF EVERY CHILD.
Note : Transcripts are compiled from uncorrected captions