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Medicaid issue is complicated

Ohio House of Representatives leaders are looking several years down the road in rejecting Gov. John Kasich’s proposal to expand the Medicaid program, because they don’t trust the federal government’s promises.

Kasich has proposed the state go along with the federal health care law mandate that Medicaid programs be expanded by the states. In Ohio, that would add about 275,000 people to the program, which is funded jointly by state and federal governments.

The governor’s analysis is that during the next three years, expanding Medicaid would be an undiluted benefit for Ohio. That is, in part, because the ”Obamacare” law stipulates the entire cost of expanded state Medicaid programs will be paid by the federal government for the first three years. After that, Washington’s burden would drop to 90 percent of the cost.

It has been estimated going along with the expansion actually would save Ohio taxpayers about $400 million during the upcoming two-year budget cycle.

But Kasich’s fellow Republicans, who control the House, seem worried the federal government will not keep its promise.

Given Washington’s history of promising allegedly economical social programs, then waiting a few years before making the true cost public, the House’s concern is grounded firmly in realism.

Ohio taxpayers now pay slightly less than one-third of the cost of the existing Medicaid program. If Washington goes back on its word with the expanded system, the annual cost to Ohioans will be in the billions of dollars.

Legislators should be concerned about the consequences of rejecting expansion. They must weigh the potential to increase costs on hospitals and the threat of shifting costs to the private sector including businesses. They must also weight the moral implications of declining care for needy Ohioans.

But legislators are absolutely right to worry about long-term implication on the budget if Washington reneges.

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