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Dionne: Obamacare's strange bedfellows

  • Ohio Governor John Kasich explains to a crowd in the Ohio Statehouse atrium why he believes the legislature should extend health coverage through Medicaid, Tuesday, July 9, 2013 in Columbus, Ohio. (AP Photo/The Columbus Dispatch, Chris Russell)

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It was the last thing the Rev. Tim Ahrens expected to do during a chat in his book-lined office at the historic First Congregational Church here: He expressed admiration for Gov. John Kasich.

Ahrens is a progressive social activist whose house of worship has deep roots in the old Social Gospel movement. He has demonstrated and organized against Ohio's conservative governor and, in 2011, even gave a kind of counter State of the State message outside the Capitol while Kasich was presenting his plans inside.

Yet Kasich, a one-time scourge of labor unions who was a top lieutenant in Newt Gingrich's revolution in the 1990s, has endeared himself to liberal and low-income Ohioans by insisting, loudly and incessantly, that his state participate in the Medicaid expansion under Obamacare. An unapologetic conservative is fighting the tea party and his own Republican legislature because he thinks the less privileged people of Ohio deserve health coverage.

Thus Ahrens' surprising confession last week, offered with a rueful smile: "One of the things I admire about John Kasich — yes, I did say 'admire' — is that if he connects to an individual who is hurting, he will respond."

And having responded on the Medicaid issue, Kasich has gone all in. "He has not wavered from that place," says Ahrens, who chairs the Central Ohio Medicaid Expansion Coalition. "He has become a crusader. He will not let go of this."

Kasich's witness is important as an expression of his commitment to a form of evangelical Christianity that places a high priority on the poor. The governor told the Wall Street Journal last month of an encounter with a state legislator who disagreed with him on Medicaid. At Heaven's door, Kasich preached, St. Peter is "probably not going to ask you much about what you did about keeping government small. But he is going to ask you what you did for the poor."

Yet at a moment when the Beltway wing of the GOP is on the verge of shaking the economy to its foundations in an effort to block Obamacare, there's also a political lesson to be drawn from Ohio and from other states where Republican governors have embraced the expansion of Medicaid that is a central component of the Affordable Care Act.

Just last week, Rick Snyder, Michigan's Republican governor, signed a Medicaid expansion bill with an explanation that President Barack Obama himself would endorse. "This is about the health of fellow Michiganders," Snyder said. In Pennsylvania, Gov. Tom Corbett once excoriated Obamacare but said he'd go along with a modified expansion. Another half-dozen Republican governors have also supported enlarging Medicaid, among them Chris Christie in New Jersey, Jan Brewer in Arizona and Susana Martinez in New Mexico.

These chief executives usually follow the party line in being critical of the health law in principle. But they have responsibilities that the radical ideologues in Washington don't have — to their local hospitals, to their economies and, yes, to their constituents among the working poor who now lack insurance. They understand the difference between "Obamacare" as a right-wing bogeyman and the Affordable Care Act as a reality.


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