Governor Kasich joined a growing number of Republican governors who have decided to expand their Medicaid programs under the Affordable Care Act.
The expansion will provide coverage to adults living at up to 138 percent of the federal poverty level.
Medicaid currently covers about two million Ohioans and accounts for about 30 percent of the state's overall budget. A nonpartisan report last month found the expansion could result in a net gain in the long run partly because it will reduce the cost of care for the previously uninsured.
Cathy Levine is co-chair of the coalition Ohio Consumers for Health Coverage and praises the governor's decision.
LEVINE: This is going to create jobs, it's going to improve the health of our workforce, it's going to bring more dollars into our economy and into our state budget, and it's going to improve the health of Ohioans.
But some say there are hidden costs associated with the expansion. Robert Alt is president of the conservative think tank Buckeye Institute. He worries that the federal government might not follow through with long-term financial support:
ALT: I think that the long-term costs for Ohio could be much more significant than those that have been projected.
Under the new law, the federal government will pick up most of the tab for new enrollees. Kasich indicated he'd change course if the feds don't come through.