When Republican leaders at the Statehouse mean business (say, curbing abortion access), they move with impressive speed. But watch the Kabuki dance they have performed on the question of Medicaid expansion, and one has to conclude they must not mean business.

House and Senate leaders stripped an expansion proposal out of the budget legislation. At the time, they promised to work on a bushel of Medicaid “reform” bills during the summer break. But as time passes, the schedule recedes. William Batchelder, the House speaker, let on this week that nothing is going to happen until the chamber convenes in October and that Medicaid legislation may not emerge until the end of the year.

Gov. John Kasich, also a Republican, made the proposal in February as part of his budget plan. Under the provision, an Ohioan who lacks health insurance and whose annual income does not exceed 138 percent of the federal poverty level ($15,856 this year) would be covered under the tax-supported program for poor families. For the first three years, the federal government would pay the full cost for those who become newly eligible, gradually reducing its share to 90 percent.

The regular federal share for Medicaid in Ohio is about 64 percent, so this share of federal funding is substantial. Better still, nonpartisan health policy analysts project that even with spending growth of 4 percent a year, it would cost much less ($39.5 billion) to expand Medicaid to an estimated 275,000 Ohioans than it would if Ohio rejected an expansion and costs continued to grow at the current rate of 7.2 percent ($43.4 billion).

A positive budget scenario is not the only argument in favor of expansion. Hospitals executives have pointed out how an expansion would improve the health of patients with chronic illnesses and reduce the millions of dollars hospitals lose in uncompensated care. Agencies that serve clients with mental health issues, drug and alcohol addictions and various disabilities indicate how an expansion would open resources to improve the quality and range of services they provide to keep clients healthy and productive.

None of this has swayed a Republican caucus that would rather not support the Affordable Care Act even if it helps Ohio and its residents. To his credit, Kasich has bucked the trend, recognizing the priority. But where is the governor, as his colleagues engage in a calculated stalling game? In Michigan, Gov. Rick Snyder, a Republican, this week won a crucial vote to expand Medicaid. Against opponents as hostile as Ohio’s, Republican governors in New Jersey, Arizona and Iowa, among other states, have found ways to build support to move forward on Medicaid expansion. Clearly, they meant business.