It's no coincidence Gov. John Kasich announced he would pursue expanding Medicaid under the Affordable Care Act while he also proposed a new two-year budget.
True, participating in the program to extend Medicaid to another 365,000 Ohioans wouldn't significantly affect the next biennial budget. The federal government would cover the full cost for the first three years, beginning in 2014.
But the impact on future state budgets might be limited, and overall the program could have a positive effect in Ohio, including better health care for more residents. That's why the governor, in making the announcement, said "I think that this makes great sense for the state of Ohio."
That's partly because the federal government is to pay the full cost of the expansion for the first three years and 90 percent thereafter. According to the Kasich administration, the federal government would give Ohio $2.4 billion to cover the newly eligible over the next two years starting in July and $13 billion over the next seven years.
Plus, the change could save the state and those who buy health insurance money because fewer people might seek medical care at emergency rooms and get more regular care from family physicians. Also, the state could save on medical care for prisoners.
And Kasich is pushing for an opt-out clause, meaning Ohio could withdraw from the program if the federal government doesn't foot is share of the bill as promised.
But the finances might not favor folks who not only pay taxes in Ohio but pay federal taxes as well. The federal government's share of the expanded Medicaid program is expected to cost $1 trillion over 10 years.
Maybe that's why Kasich earlier had criticized Obamacare as a "massive new tax on the middle class."