Dan Sewell
and Julie Carr Smyth

CINCINNATI: The U.S. Supreme Court’s ruling upholding the heart of President Barack Obama’s health-care overhaul aimed at uninsured people also ensures that Republicans will highlight their continued opposition for the fall campaign in the pivotal state of Ohio.

The state’s former Democratic governor said Thursday that the Republican opponents risk alienating Americans who will benefit from the changes. Ted Strickland, an Obama campaign co-chairman, also called on his Republican successor’s administration to get moving on a state health-care exchange.

Gov. John Kasich and Lt. Gov. Mary Taylor said they were analyzing a court ruling they found disappointing and were concerned about dramatically higher costs it could mean for Medicaid and other coverage.

She said she and Kasich think the “best solution for Ohio” is for Obama to be replaced by Republican Mitt Romney and for the health-care law to be repealed.

“This matter will now be fought out in the political arena, again,” said Ohio Attorney General Mike DeWine, also a Republican. “It makes this issue the pre-eminent issue of the presidential campaign. ... People will have the ability this fall to do what the United States Supreme Court would not do today, and that is to repeal Obamacare.”

The race between Obama and Romney is expected to be close in Ohio, a swing state likely to be crucial to Romney’s chances of winning the general election.

Republican Sen. Rob Portman said that Ohio voters have already expressed their opposition to the law and that health care is “one of the issues that will help decide the election in Ohio, and therefore around the country.”

Ohioans voted heavily against the overhaul’s mandated coverage in a largely symbolic referendum last year, and statewide polls this year continue to indicate most Ohioans are oppose the law.

“It gives Romney a target if Ohioans continue to not like the health-care law,” said Peter Brown, assistant director of the Quinnipiac University Polling Institute.

Brown said the decision was a boost to Obama’s re-election campaign because it allowed his signature legislation to stand. He said some Ohioans might now think the law is acceptable because it has been to the Supreme Court, but it’s too soon to tell.

“Over the next four months, the question is, can Romney essentially make lemonade out of lemons?” Brown said. “And that’s really the unknown question.”

DeWine said the state will continue to be part of a lawsuit disputing the health-care law on the grounds it compels people to violate their religious principles, and U.S. House Speaker John Boehner, R-West Chester, pledged to work for its repeal.

Taylor, who serves as state insurance director, has frequently criticized the overhaul, while saying the state needed more information from the federal government on the exchange plans.

“I think we find ourselves well behind most other states,” Strickland said. “So she needs to stop talking and go to work and pull together the kind of effort that’s going to be necessary to get these exchanges up and running.”

Taylor said Ohio’s leadership doesn’t see an advantage to a state-run exchange program, nor where funding for exchange costs and additional coverage — such as $369 million more in state matching funds for Medicaid in 2014 — will come from.

“We are concerned that this will cripple the recovery in Ohio,” Taylor told reporters.

She also said higher state costs could lead to cuts in state Medicaid services. She said the state is still studying other implications of the ruling.

“Everything is on the table,” she said.

Meanwhile, the nonprofit Health Foundation of Greater Cincinnati said its surveys have indicated most Ohioans don’t understand how the health-care changes will affect them personally, and it urged people to seek information about sections of the law that have already taken effect and what will happen in the future.