COLUMBUS, Ohio (AP) -- Hospitals, insurers and religious organizations are seeking support from state lawmakers to expand Medicaid, even as Ohio's governor has yet to say whether he'll push to cover more low-income people now left out of the federal and state program.
Republican Gov. John Kasich is expected to reveal his decision Monday in his state budget proposal.
In the meantime, a coalition of expansion supporters called the Ohio Alliance for Health Transformation has been encouraging lawmakers through face-to-face meetings and phone calls to back expanded coverage under President Barack Obama's Affordable Care Act. Their partners also are making the pitch locally with letters to the editor and public meetings.
More than 1,000 people recently turned out for a rally at a Cleveland church to urge state leaders to expand Medicaid in Ohio. And in Toledo, the leaders of the two biggest hospital systems wrote letters to newspapers calling for the expansion.
George Weigly is among the health care executives who have shuffled from office to office at the Statehouse in Columbus, promoting the expansion to state lawmakers on behalf of the community mental health center for which he works.
"The Affordable Care Act is the law of the land right now," Weigly said in an interview. "We need to recognize that. And if we don't, we're going to put Ohio at a competitive disadvantage."
Weigly, who heads Tri-County Mental Health and Counseling Services Inc. in Athens, said expanding coverage would allow the center to see people who need treatment. Otherwise, health care professionals are forced to turn patients away.
"That stresses people out and drives people out of the business," Weigly said.
The conservative Buckeye Institute think tank and the Ohio Liberty Coalition have voiced concerns over expansion. Among other problems, the groups say it's dangerous to assume Washington will uphold their share of the cost.
"If Gov. Kasich intends to implement an expansion of Medicaid, there's likely to be a firestorm of opposition," said Jack Painter of the Ohio Liberty Coalition. "The state can't afford it, and it's doubling down on a failed program."
Painter said his coalition of 75 tea party and other related groups are waiting to see what Kasich does before taking action.
The federal law expanded Medicaid to cover low-income people making up to 138 percent of the federal poverty level, or about $15,400 a year for an individual. That provision will mainly benefit low-income adults who do not have children and currently can't get Medicaid in most states. Separately, the overhaul provides subsidized private insurance for middle-class households.
Medicaid currently covers roughly 2.3 million low-income and disabled people in Ohio. And about 456,000 uninsured Ohioans would gain health care coverage by 2022 under the expansion, according to the study from the Health Policy Institute of Ohio, a nonpartisan policy organization.
For states deciding to make Medicaid available to more people, the federal government will cover 100 percent of the cost of the first three years of the expansion, gradually phasing down to a 90 percent share -- still more than states have traditionally received.
Should Kasich go for the expansion, he'll need the backing from the GOP-controlled Legislature.
It'll be a tough sell. Many Republicans, such as state Rep. Barbara Sears, are philosophically opposed to Obama's health care law and its mandate that virtually everyone in the United States have health coverage.
Sears, a Sylvania Republican, said she's been in "wall-to-wall" meetings on health care.
Medical providers have urged her to back it. But she's hearing "no" from constituents who voted overwhelmingly against the overhaul's mandated coverage in a largely symbolic referendum in 2011.
Sears has not yet taken a position on expansion, but she says she's giving it a hard look.
"I'm charged with more than just my opinion," Sears said in an interview. "I'm charged with trying to figure what's best for Ohio."
Other lawmakers, such as state Sen. Bill Seitz, have received emails from expansion supporters.
John Prout, the CEO of a medical provider in Cincinnati, told Seitz expanded coverage "would help address the challenges faced by families without health insurance."
Prout pointed out to Seitz that as the head of TriHealth, he represents nearly 13,000 employees and "the tens of thousands of patients we care for from your district each year."
Seitz, a Cincinnati Republican, wasn't swayed.
In a written response to Prout, the senator cited a lack of clarity from the federal government over whether a state could initially take the money to expand and then later reverse course. He also said he sees the expansion as furthering what he called the nation's "unsustainable spiral of borrowing."
"For these reason, I am highly dubious over the wisdom of the course being proposed," Seitz wrote.