In Washington this fall, our Congressional delegation—tanned, rested and ready after a five-week summer vacation—will debate whether or not to shut down the government and stiff our creditors, all for the noble cause of denying health insurance to those pre-exiting conditioned “pariahs” enjoying the benefits of Obamacare.

Meanwhile, in Columbus, members of the Ohio General Assembly will be sucked back into their own health care debate: should they take Gov. Kasich’s heretical advice to expand Medicaid to about 300,000 more Ohioans, paid for with billions of federal cash? Or should they succumb to the demands of the Tea Party, refusing those dirty federal dollars, no matter what the benefit to Ohio?

The “devil’s bargain” on the table is not in dispute: if Ohio expands Medicaid coverage, currently at 90 percent of the federal poverty level, to those at 138 percent ($15,400 a year for an individual and $32,000 for a family of four), then the federal government will pick up 100 percent of the additional Medicaid tab for three years and 90 percent thereafter. A nonpartisan study conducted by Ohio State shows that by expanding the program and capping Medicaid spending, the state will actually save $1.4 billion by 2025. That’s right: more folks get health care, billions more get paid to Ohio’s health care providers, and the state saves money.

Lower income workers and their kids will get better, more reliable health care. But the money—more than $12 billion of it—will go to Ohio’s hospitals, doctors and other health care providers. That means more jobs—an estimated 23-28,000 new jobs in health care and other industries, and more money spent by those new workers throughout Ohio’s economy.

Businesses and workers will save money too: hospitals will “give away” less emergency care to the poor, costs now passed on to those with private health insurance. Businesses employing low-wage workers covered by Medicaid will be off the hook when it comes to providing them coverage.

A broad coalition of Ohioans support expansion. Liberals see it as a way to provide better care for the poor. Businesses will save health insurance costs and Ohio will recapture billions in tax dollars we ship off to Washington that now get spent in Kentucky, Alaska and Afghanistan. Conservative papers like our Enquirer and the Columbus Dispatch support it. When the Republican Governor, organized labor, Democratic legislative leaders and the Chamber of Commerce all agree on something, it must be a no-brainer, right?

Well, of course not.

All that feel good, bipartisan consensus creates a big stink for the hardcore conservatives in the General Assembly. There’s something that sticks in the craw of a real conservative when the subject of broadening a government benefit comes up. Pushing back, local state Rep. John Becker wants to cut Medicaid eligibility to only 34 percent of the poverty rate, cutting hundreds of thousands off Medicaid, even pregnant women and disabled workers. Their arguments against providing health care to more Ohioans boil down to these:

Health care is a product, not a “right”, like soft drinks or cars. You get what you can afford. Why should folks without good jobs (or a hefty trust fund) be handed a Coke or a Caddie? Let them settle for Super K Cola, a used Fiesta, or the emergency room when their 3-year-old’s asthma acts up.

Sure the federal gubmint says it will pick up this tab, but that just adds to the federal deficit. We won’t stand for that! Let the bucks go to New York or California instead.

By handing out “free” health care, we simply encourage folks to be shiftless losers, as if a family of four living off $32,000 a year is “summering” on Lake Michigan, while the rest of us are slaving away at the office.

Health care is overrated. Tea Partiers are trotting out studies questioning whether seeing a doctor, or treating chronic disease really makes someone healthier. So tax dollars spent on health care is wasted. (I’m not making this up!)

But worst of all….It’s Obama’s idea. A “Blame Obama syndrome” has deranged the right, particularly after the President won Ohio’s electoral votes again in 2012. Facts cannot get in the way. You can see it in polls, like the one in Louisiana, where a sizeable chunk of Republicans blame Obama for the failed response to Hurricane Katrina—the one that hit in 2005. A third of GOP voters are convinced the President is Muslim, and 43 percent believe he was not born in the United States.

No matter that Gov. Kasich, and other conservative stalwarts like Govs. Brewer in Arizona and Snyder in Michigan have embraced Medicaid expansion. The fact that this scheme originates in Obamacare is the ultimate kiss of death for true Tea Party believers.

As the General Assembly debates the future of Medicaid in Ohio this fall, we will discover who actually runs Ohio’s government. Is it Gov. Kasich and others from both parties who see at least some role for state government in improving the lives of Ohioans, or the Tea Partiers, who will not let facts get in the way of their vendetta against our President?

Don Mooney is a partner at the Cincinnati office of Ulmer & Berne LLC, and is active in local politics.