By Elise Viebeck - 02/04/13 07:02 PM EST
Ohio's Republican governor said Monday that he supports expanding Medicaid under President Obama's healthcare law.
John Kasich, who has long criticized the Affordable Care Act, is the fifth Republican governor to accept one of the law's most substantial changes.
Kasich proposed Monday to extend coverage to adults living at or below 138 percent of the federal poverty line, or nearly 600,000 Ohioans. The federal government will cover 100 percent of the cost for the first three years and slowly decrease its contribution over time.
Kasich now has to convince the state legislature to support his decision. He reportedly argued Monday that expanding Medicaid would add to state coffers and free up funds for other uses. It would also ensure that hospitals are properly compensated when they care for low-income patients, he said.
Ohio's Medicaid program currently covers people at 90 percent of the poverty level. Kasich is up for reelection in 2014.
Families USA President Ron Pollack said in a statement that any other decision by Kasich would have been "fiscal malpractice."
"With the federal government picking up 100 percent of the expansion costs over the next three years and never less than 90 percent thereafter, states will receive unprecedented federal help in serving their citizens," said Pollack, whose organization supported healthcare reform.
"Now that Republican governors in Arizona, Nevada, New Mexico, North Dakota, and Ohio have decided to implement the Medicaid expansion, we can expect other Republican governors to follow suit," he said.
— Updated at 2:24 p.m.