Ohio House Republicans are poised to reject the Medicaid expansion and the $500 million per year in federal funding that would come with it for the next two years — a move that has united Republican Gov. John Kasich, Ohio Democrats, mental health advocates and other health groups in opposition. The Medicaid expansion is part of a measure in the Affordable Care Act (“Obamacare”) that encourages states to expand their Medicaid programs to include anyone at or below 138 percent of the federal poverty level with the use of federal funds. For the first three years, the federal government would pick up the entire tab for the expansion. After that, payments would be phased down over time so the federal government would be paying 90 percent of costs. Ohio House Republicans oppose the measure because they say they’re worried federal funding will dry up in the future, even though there is no historical precedent of the federal government failing to pay its commitment to Medicaid. Kasich’s proposal for the Medicaid expansion includes an automatic trigger that would immediately stop and retract the expansion if federal funding falls through, but Ohio Republicans previously voiced concerns in hearings that the trigger would hurt Ohioans who have become accustomed to government-provided health insurance without any plan to make up for the lost coverage. A report from the Health Policy Institute of Ohio found the expansion would help insure 456,000 Ohioans by 2022 and save the state money in the next decade by producing economic growth and shifting health-care expenses from the state to the federal government. For advocates of mental health and addiction treatments, Ohio House Republicans’ rejection of the Medicaid expansion and other budget items means mental health and addiction services will miss out on $627 million per year, according to a report from the Office of Health Transformation. Ohio House Republicans’ budget plan would include $50 million more annual funding for mental health and addiction services, but that’s also not enough to make up for the $140 million in annual funds cut around the state since 2002 and the $17 million being cut over two years through the dissolution of the tangible personal property tax replacement funds. Cheri Walter, chief executive officer of the Ohio Association of County Behavioral Health Authorities (OACBHA), says the Medicaid expansion is a great opportunity to emphasize mental health services around the state. “On the mental health side, ... sometimes it can take two or more years for someone to get a disability determination that makes them Medicaid eligible,” she says. “In addition to making more people Medicaid-eligible, it will speed up the process for many others.” Walter says for addiction patients in particular, getting access to health services can be difficult because alcoholism and other forms of addiction are not technically disabilities. By including more income levels in the Medicaid program, less people will fall through the cracks, she says.OACBHA was one of the many groups that rallied at the Ohio Statehouse Thursday in support of the Medicaid expansion. The crowd, which received support from Ohio Democrats and Kasich, was estimated to reach 2,500. Until the U.S. Supreme Court ruling on Obamacare, the Medicaid expansion was required, but the court ruled that states must be allowed to opt in and out. The Medicaid expansion was one of the few parts of Kasich’s budget plan that Democrats and progressives approved, while the two other major proposals in Kasich’s plan — school funding and a tax cut proposal — were criticized for disproportionately benefiting wealthy Ohioans (“Smoke and Mirrors,” issue of Feb. 20).

City Council’s Livable Communities committee is expected to hear about and likely vote tonight on the city’s first master plan in more than 30 years. The plan, which CityBeat previously covered, seeks a renewed emphasis on Cincinnati’s urban core through new infrastructure and transportation options. It was put together largely based on public feedback. The “fiscal cliff,” which is really more of a self-induced austerity crisis from the federal government, could seriously hurt Ohio schools. Educators around the state, including Cincinnati schools, are expecting a cut of about 8 percent in federal funding. A Cincinnati Public Schools levy was recently renewed after a decade of cuts and problems at the school district. Gov. John Kasich has finally made a decision for Obamacare: The state will not run the health exchanges that are a big part of the plan. With the governor’s decision, managing the health exchanges now falls to the federal government. Rob Nichols, Kasich’s spokesperson, defended the governor’s decision by pointing out that even if the state managed the exchanges, the federal government would always have the final say, creating an arrangement “just doesn’t make sense for the state.” Exchanges are subsidized, heavily regulated insurance markets that will go into effect in 2014 as part of Obamacare. They are supposed to bring down costs by offering more transparent, open competition through a fair, regulated marketplace. Cincinnati’s economy is being carried largely by manufacturing, and that looks likely to continue. Business schools at the University of Cincinnati, Miami University, Xavier University and Northern Kentucky University were found to be among the nation’s best, according to the Princeton Review. Still, none of the schools made the top 10 rankings for the review’s 11 categories. City Council is holding a public hearing today to find out what the city should do with casino revenue. Some of the council members already have plans, but City Council wants public feedback to shape the final decision. In other council news, the Human Services Advisory committee recommended funding for 56 out of 58 programs. The two programs left out are the Over-The-Rhine Kitchen and a social education program offered by the Starfire Council of Greater Cincinnati. Cincinnati’s Metro bus service will be getting a revamp in the next few years. The company released a comprehensive plan with short-term and long-term goals that focus on increasing travel speed and reach. Charter schools are where a large amount of Ohio kids are getting their education. This is despite the fact that, in general, traditional public schools perform better than charter schools, according to state standards. Food stamps for Ohio families are getting reduced by about $25 a month. The good news is the cut is lower than expected. The Ohio Department of Rehabilitation and Correction released a “re-inspection report” for the Lake Erie prison owned by Corrections Corporation of America. According to the new report, CCA has come a long way and corrected many of the violations the state originally found in the private prison. The last report found the prison, which CCA bought in 2011, was riddled with problems. CityBeat looked at private prisons, their problems and the shady connections between state officials and CCA in an in-depth report. A report found more Ohioans are taking advantage of a national settlement that lets households refinance their mortgages. In total, more than 4,500 Ohioans have refinanced for $165 million in consumer relief. Still, many eligible Ohioans are not taking advantage of the opportunity. Here are pictures of a tiny octopus, fighting female robots and an orange-powered battery.

Gov. John Kasich is refusing to work with Obamacare. In a letter to the U.S. Department of Health and Human Services, the governor today declined to have the state government run its health insurance exchange. With the move, the federal government will be put in charge of managing Ohio’s exchange. Exchanges are subsidized, heavily regulated insurance markets that will go into effect in 2014 as part of Obamacare. They are supposed to bring down costs by offering more transparent, open competition through a fair, regulated marketplace. As part of Obamacare, states have to decide by Dec. 14 whether they’ll manage the exchanges or let the federal government do it. Conservatives were quick to praise Kasich's decision. Americans for Prosperity applauded the choice in a statement. The Buckeye Institute put up a blog post calling the move “the right decision for Ohio.” The Coalition Opposed to Additional Taxes and Spending (COAST) called the move the right choice. At first, the choice seems like a contradiction for conservatives. After all, they’re the group that normally rails against a big federal government. Why let the federal government take over a new, major part of the health-care system? Rob Nichols, Kasich’s spokesperson, justified the decision in a statement: “Ohio would have no flexibility to shape an exchange to our needs and its costs will be so high that it just doesn’t make sense for the state to operate a health exchange under Obamacare.” In other words, even if the state managed the exchanges, it would still have to answer to the federal government. In his letter, Kasich also stated Ohio will not give up its right to regulate the insurance market. So the federal government will have the final say on exchanges, but Kasich wants to keep the rest of the market under state regulatory control. The state will also keep control over deciding Medicaid and Children’s Health Insurance Plan (CHIP) eligibility. Ohio is not alone in declining to supervise exchanges. Other states have signed off on letting the federal government manage them, including Florida and Texas. Still, Republicans may want to proceed cautiously. Recent polling has shown that support for repealing Obamacare has massively dropped. That shift could reflect reality catching up to public opinion. Republicans tend to rail against Obamacare by saying it’s too expensive, but a Congressional Budget Office report found repealing Obamacare would increase the deficit by $109 billion between 2013 and 2022.

If Tuesday's election was supposed to be a strong message from social progressives, women and younger voters, Ohio Republicans are not getting it. Instead, they are continuing their pursuit of the heartbeat bill. That’s what Ohio Senate President Tom Niehaus told The Cincinnati Enquirer yesterday.  At the time the heartbeat bill was originally suggested, it was called the most radical anti-abortion bill in the country. Yet Republicans, in cooperation with anti-abortion organizations, are pushing a version of the bill once again. Ohio Republicans have also shown interest in continuing their crusade against Planned Parenthood, according to Kellie Copeland, executive director of NARAL Pro-Choice Ohio. Cincinnati’s budget proposal is coming later this month. Specifically, Vice Mayor Roxanne Qualls says it will arrive Nov. 26. City Manager Milton Dohoney Jr. and his budget team are currently working on a budget to close a $40 million general fund deficit. One idea that was suggested recently in a memo was privatizing parking services, but it faces skepticism from Councilman P.G. Sittenfeld. The budget will first go through Dohoney, then the mayor and then City Council. However, this calendar year’s budget will only cover six months, and then the city will transition into filing budgets based on fiscal years on July 1.To match some of Obamacare’s requirements, Ohio officials are considering a hybrid approach to health care exchanges. The exchanges are federally regulated insurance markets. As part of Obamacare, states have the option of creating their own exchange programs, which have to be approved by the federal government; setting up a hybrid approach, which is what Ohio is looking into doing; or putting the responsibility on the federal government. During the lame duck session, the Ohio legislature will take up legislation to regulate puppy mills and election reform. Regulations on puppy mills were previously covered by CityBeat when a group tried to get dog auctions banned in the state. Election reform could mean a lot of things. The current Republican-controlled legislature previously tried to restrict and limit in-person early voting before repealing its own rules. Ohio Secretary of State Jon Husted has also suggested “more strict” voter ID laws. In other election news, an upset federal judge demanded Husted’s attorneys explain a last-minute directive that changed rules on provisional ballots. U.S. District Court Judge Algenon Marbley told the lawyers, “You have a lot of explaining to do.” The directive, which Husted sent out Nov. 2, shifted the burden of providing identification for provisional ballots from poll workers to voters. Voter advocates argued the directive was against Ohio law and would lead to more provisional ballots, which are ballots filed when a voter’s eligibility to vote is uncertain, being wrongly rejected. Husted and Republicans were heavily criticized for alleged attempts at voter suppression in the run-up to the election. City Council approved a $750,000 tax break for the E.W. Scripps Company. As part of the deal, Scripps will hire for 125 new local jobs and retain 184 current employees. The Wall Street Journal covered Cincinnati’s “pie war” between Frisch’s and Busken Bakery. CincyTech, a nonprofit venture organization, has invested $14.3 million since it began five years ago. Its investments, which focus on information technology and life sciences, have helped create more than 360 jobs, according to company officials. As part of a national movement, Cincinnati-based Kroger will be making an effort to hire more military veterans. Republican Gov. John Kasich is focused on his re-election bid for 2014. When asked about whether he will run for president in 2016, Kasich said he has not made any announcements. The news came shortly after the Ohio Democratic Party began printing signs that say “Kasich... you’re next” on one side and “2014 can’t come soon enough” on the other. Ohio Treasurer Josh Mandel won’t be leaving state politics any time soon. He says he’ll be running for re-election in 2014. Mandel is the Republican who led a failed bid for U.S. Senate against Democratic incumbent Sherrod Brown. His campaign was notorious for its dishonesty. U.S. Sen. Rob Portman, an Ohio Republican, may take up running the National Republican Senatorial Committee in 2014. That would put him in charge of managing the Republican Party’s senate campaigns for the year. Republicans are expected to make gains in the U.S. Senate in 2014 because 20 Democratic seats will be up for grabs, in comparison to 13 Republican seats, and 12 of the Democratic seats are in swing or red states. Democrats in the U.S. House of Representatives won the popular vote, but they ultimately lost the House. The culprit for the discrepancy seems to be politicized redistricting. In Ohio, the Republican-led committee redrew congressional district boundaries to give Republicans an advantage. The First Congressional District, which includes Cincinnati, was redrawn to include Republican-leaning Warren County, which slanted the district in favor of Republicans and diluted the say of Cincinnati’s Democratic-leaning urbanites. On this year’s ballot, Issue 2 attempted to tackle the redistricting issue, but Ohio voters overwhelmingly voted it down. Some scientists are really excited by the discovery of “Super Earth.” What doomed the Mayans? Climate change.

A performance audit for the Cincinnati Service Department could save the city $3.7 million. The audit claims $2 million could be saved every year if the city privately contracted solid waste collection and street sweeping. An additional $1.7 million could be saved if the city reduced overtime, sick leave and staffing levels. Along with other recommended savings measures, the changes could amount to 7.9 percent of Cincinnati’s budget. Trayvon Martin’s parents will be visiting Cincinnati today to take part in the national conference hosted by the Children’s Defense Fund. The conference will target violence and race-related issues. Procter & Gamble and the U.S. Environmental Protection Agency have teamed up to improve environmental sustainability at manufacturing facilities and supply chains. The worst U.S. drought in half a century is putting pressure on oil and gas companies to recycle and conserve water used for fracking. Fracking uses millions of gallons of water to free oil and gas from underground rock formations. Gay marriage has generated $259 million in economic activity in New York City. The Congressional Budget Office said repealing Obamacare would increase the deficit by $109 billion. Voters sometimes punish politicians for bad weather. Some scientists are saying the plot of The Amazing Spider-Man might not be too far off from reality.

Northern Ohio counties are starting to receive $19 million from Cleveland casino tax revenue. Cincinnati and Hamilton can expect a similar revenue boon next year when the Horseshoe Casino opens on Feb. 2013. Of course, the casino (and its revenue) could have been coming this year, but Gov. John Kasich blocked construction last year to protect his tax plan.  The Enquirer over the weekend did an investigative piece on ER “superusers” — individuals who can sometimes cost the health-care system as much as $1.3 million due to a lack of health insurance. Hospitals have said that this "charity care" could be curtailed by Obamacare's Medicaid expansion and save the state money, but Kasich claims the Medicaid expansion is too costly for the state.  The Ohio Board of Regents is considering banning smoking on all public campuses. Smoking is already banned in buildings, but health concerns may lead to a bigger ban. Toledo Public Schools used “scrubbing” to improve report card scores. The Board of Education claimed such cheating could be a “state-level problem.” Democratic Senator Sherrod Brown and his Republican opponent Josh Mandel have settled on a day to debate: Oct. 15. Former Reds shortstop Barry Larkin was inducted into the Hall of Fame Sunday. Here’s CityBeat’s C. Trent Rosecrans’ column offering current players’ thoughts on Larkin. The Great Ohio River Swim was postponed Saturday because of high bacteria levels. Not very surprising. In science news, a European agency became the first in the Western world Friday to approve a gene therapy treatment for a rare genetic disease.