Financial decision confronts Kasich

Monday, Ohioans should find out whether Medicaid – the state-federal health-care program – will expand as part of Obamacare. That’s the day Gov. John Kasich plans to propose the next two-year state budget.

Although, under the Affordable Care Act, the federal government would cover costs of extending the reach of Medicaid for the first few years, Kasich is expected to decide whether Ohio will opt out when the budget is unveiled next week.

The federal subsidy would drop to 95 percent in 2017 and eventually fall to 90 percent a few years later. Easing the eligibility limit could add more than 500,000 clients to Medicaid – at a cost of about $550 million a year to Ohio.

If that doesn’t sound like much compared to a $55 billion biennial budget, remember that’s roughly the amount of state support local communities lost during the current budget.

Proponents argue adding more low-income residents to Medicaid would save at least that much money for Ohioans who pay taxes and health insurance premiums. That’s because fewer people would seek care at emergency rooms. Also, health care for inmates would be covered.

Critics know projected savings aren’t always realized – while new and expanded public programs tend to go on costing money (or adding to the national debt) on a continual basis.

This is why Kasich, who has a substantial business background, has to put that knowledge and experience to work sorting out the likely economic impact of expanding Medicaid in Ohio.

Even if he were to seek, and win, re-election, he would leave office before the state’s share of the burden would kick in. Before Ohio taxpayers are stuck with that bill, they need to be convinced expanding Medicaid would be the beneficial – and prudent – thing to do.