There's a straightforward appeal here, even for a dedicated small-government conservative like Kasich. It's free federal money for three years (with 90 percent federal funding after that) to get insurance for more than 285,000 lower-income Ohioans. That's especially relevant because Ohio lags the nation in key health indicators. Kasich also couched the move in religious terms: "Now, when you die and get to the meeting with St. Peter, he’s 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. You better have a good answer."
That's essential background for what Kasich told the Associated Press Monday when asked about repealing the Affordable Care Act. "That's not gonna happen," he said. "The opposition to it was really either political or ideological. I don't think that holds water against real flesh and blood, and real improvements in people's lives."
Mr. Kasich said he was working on his own replacement for Obamacare but did not offer specifics. “I’m in favor of repealing Obamacare,” he repeated. “That’s all I can tell you.’’
This has been a standard Republican dodge since the ACA passed—we're working on a replacement, and we'll tell you about it, um, sometime soon. (Jeff Young has a hilarious demonstration of this tendency here.) The substance of that replacement matters, needless to say—not least to the 285,000 Ohioans newly dependent on Medicaid expansion staying in place.
Maybe the AP got it wrong, or maybe Kasich regretted his blunt words. Giving Kasich the benefit of the doubt, it's not clear what he suggests is doable. Extricating the Medicaid expansion from the rest of the law, and leaving only the expansion in place, would be a difficult and potentially costly move, since the law involves an elaborate balancing of revenue and expenses. Other Republicans have suggested repealing the law but maintaining a ban on discrimination for preexisting conditions. That's politically savvy, since the ban is popular, but implausible, since the law pays for the ban by mandating that everyone hold insurance.
On the other hand, Kasich's original statement isn't so far off from what he said when he expanded Medicaid, and it's hard to argue with their logic. If Republicans win control of the Senate in November, they'll still be unable to bypass an Obama veto on any repeal. And even if they win the White House and maintain control of Congress in 2016, they will likely find that withdrawing a massive benefit for many Americans is politically impossible (as some conservatives, including Ted Cruz, have warned).
Even if Obamacare is irreversible, it's not politically tenable to say such a thing in today's Republican Party. Even if it's not clear that Kasich's hasty walkback makes a lot of sense as policy, it does seem—as Philip Klein notes—like another indication that Kasich would like to run for president in 2016. If he does, he'll continue to be caught in a vise by Obamacare. Candidate Kasich would wish to appeal to Democrats and moderates by pointing out that he successfully governed in a purple state and expanded healthcare for needy citizens; maybe comments like this could even position him as a bold truthteller, conservative but coldly realistic. Yet he'd also want to appeal to Republican primary voters who abhor the Affordable Care Act. Those are two hard masters to serve.
Pity the poor Republican presidential hopeful, too.