In 2010, Democrats on Capitol Hill passed the Affordable Care Act. They decided to tax Americans who do not buy health insurance, and to require states to extend their Medicaid programs to more people.

The U.S. Supreme Court let stand the tax on people who don’t purchase insurance, but said Democrats could not force states to expand Medicaid.

Governors, unlike members of the U.S. Senate, do have to balance budgets. Accordingly, officials in many states are doing the math involved in expanding Medicaid.

It’s not pretty.

In the 2008-2009 budget year, West Virginia’s Medicaid program cost $2.4 billion. State taxpayers forked over $540 million of that, according to the nonpartisan Council of State Governments.

In the fiscal year that began July 1, the total cost of the state’s Medicaid program was $3 billion, and state taxpayers’ share had risen to $860 million.

“Expanding Medicaid under the overhaul would increase the state’s share of costs by an average of $27.3 million annually for the first six years, according to estimates from the nonpartisan Kaiser Commission on Medicaid and the Uninsured,” wrote Lawrence Messina of The Associated Press.

But a federal government that has run Americans’ national debt to almost $16 trillion would “fully cover the state’s share for the first three years, and then offset the increased costs by gradually decreasing amounts,” Messina explained.

Gradually decreasing amounts of what?

Borrowed federal money?

Congressional Democrats passed the Medicaid entitlement and claim credit for it. They passed to statehouse Democrats the responsibility for raising state taxes to pay for it.

Neat trick.

Earl Ray Tomblin has politely asked Health and Human Services Kathleen Sebelius for more details.

Perhaps he should also ask the former governor of Kansas which state taxes he should raise to pay for Medicaid.

— Distributed by The Associated Press