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Dr. Daniel Skinner's poster unravels the politics of Medicaid expansion in Ohio. Through graphic representations of key political, ethical, and policy dynamics, I show why Governor John Kasich has come to see the Medicaid expansion issue differently than most of the members of his Republican caucus, going so far as to call it “a matter of life and death.” This position, I show, owes in part to the different responsibilities that governors have within health care policy-making, as well as the unique politics of the state of Ohio. Medicaid expansion is likely to happen in particular because it promises to have a net positive impact on Ohio’s budget, bring billions of federal dollars into Ohio, and create thousands of jobs. After explaining why Kasich has positioned himself in support of Medicaid expansion, I suggest that Kasich and Ohio Republican’s resistance to the Patient Protection and Affordable Care Act more generally is likely to follow suit over coming months and years. This change of heart, I argue, is likely to occur for the same basic reasons that Medicaid expansion is all but assured.

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Public Affairs, Public Policy and Public Administration

The Politics of Ohio Medicaid Expansion