COLUMBUS, Ohio (AP) — Gov. John Kasich hasn’t given up hope that the Legislature will expand Medicaid under the federal health care law, even though the plan is unlikely to be included state’s two-year budget.

Kasich, a Republican, told reporters Wednesday that he’s giving lawmakers some breathing room to review Medicaid, the federal-state health care program for the poor and disabled.

“I’ll be combative when I have to be combative,” he said. “But there are times when you just have to be patient, and I’m willing to be patient here with our friends in the Legislature.”

Kasich’s fellow Republicans who control the Ohio House dropped Medicaid expansion from the state’s two-year budget before sending it to the Senate last month. And the Senate’s GOP leader has said his chamber’s version of the spending plan won’t include expansion.

House lawmakers have started examining potential changes to Medicaid and exploring what the state can do to give beneficiaries a pathway out of the program and into private health care. Senate President Keith Faber, a Celina Republican, also has said that Medicaid reform is not dead in Ohio.

Supporters of extending health coverage to more Ohioans are also showing some patience.

A Cleveland-based policy organization that had been working on putting the Medicaid issue to a statewide vote said Wednesday it will hold off any further work until July.

John Begala, of the Center for Community Solutions, said the organization and its partners have plenty of time to pursue a ballot initiative if the Legislature fails to act. And in the meantime, the coalition is focusing its attention on supporting the governor and Legislature in getting Medicaid expansion adopted, he said.

Kasich has continued to make his pitch that the state should move forward with extending the program to cover thousands of more low-income Ohioans.

The governor stressed the importance of the expansion to participants at a mental health awareness event Wednesday at the Statehouse.

Medicaid expansion would give mental health providers the resources they need to give patients help, hope and a chance at a normal life, Kasich said.

“But we have to tell people about why it matters and who the folks are that have to battle each and every day the challenges that come with mental illness,” he said, speaking out to a crowd from the steps of the Capitol.

Kasich’s administration estimates that rejecting expansion will mean the loss of $700 million over the next two years for medical care and treatment programs for people with mental illness or substance abuse problems.

The Medicaid expansion is one of the key components of Democratic President Barack Obama’s federal health care law.

Opponents of Medicaid expansion fear being stuck with the long-term costs of the program, which now is being paid for mainly by the federal government.

Many conservatives also are philosophically against the idea of expanding government programs and opposed to Obama’s law, which calls for mandated health coverage.

The federal law expanded Medicaid to cover low-income people making up to 138 percent of the federal poverty level, or about $15,400 a year for an individual. The provision mainly benefits low-income adults who do not have children and can’t get Medicaid in most states.

The U.S. Supreme Court later gave states the choice of participating in an expanded Medicaid program, which Kasich has supported.

Roughly 366,000 Ohio residents would be eligible for coverage under the Medicaid expansion beginning in 2014 if it’s approved. The Kasich administration expects the state to see $13 billion from the federal government over the next seven years to cover those newly eligible for Medicaid.

Asked about whether he’d be open to a ballot initiative on Medicaid expansion, Kasich said Wednesday, “I’m for it however we get there. I would love to think that this could be done, that the Legislature could do it, and I haven’t given up hope on that at all.”

(© Copyright 2013 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

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