West Virginia's Medicaid program already threatens to drown the state budget in red ink. Expanding it as the federal government demands could bring about a very real budget crisis.
Medicaid is jointly funded by the state and federal governments, but the state's share is set to increase. That will make it difficult enough to keep the program afloat without adding the 130,000 new clients mandated under the national health care law.
Proponents of expansion say it actually could save the state money by lessening the cost of "charity care" absorbed by health care providers.
However, that would come at a heavy price, estimated at as much as $200 million a year, to West Virginia taxpayers.
Gov. Earl Ray Tomblin wisely has taken a cautious approach to the question. He wants more reliable information on costs and benefits. Consultants are to be paid about $800,000 to study Medicaid expansion and provide those answers.
That seems like a lot of money, and it is. But it is a small price to pay to give state policymakers a solid basis on which to decide whether to expand the Medicaid program.
No decision should be made unless and until legislators are comfortable it will help - not burden the state.