THE YEAR 2014 is only 66 days old, yet already Virginia has forfeited $330 million in federal funds — funds already paid to Uncle Sam by taxpayers — as a result of its delay in expanding Medi­caid to cover up to 400,000 lower-income and uninsured Virginians. With each passing day, the state leaves another $5 million in federal funds unclaimed. It has also passed up another $32 million so far this year in lost savings, as well as tax revenues that would be generated by the creation of some 20,000 health-care jobs.

The House Republican opposition to expansion is almost purely ideological; like most ideologies, it relies on faith more than facts.

Republicans in the House of Delegates, who have dug in their heels to block Medicaid expansion, do not dispute these figures, which were calculated by the Commonwealth Institute, an independent group that backs the expansion. They offer no real rebuttal to business groups that argue unlocking the federal funds would boost Virginia’s economy.

The state Senate, with Republican support, has backed an expansion plan that relies on market-based insurance. But House Republicans, led by Speaker William J. Howell (Stafford), are deaf to financial prudence and plain horse sense. For years, they blithely expanded the state’s Medicaid program on the basis of 50-50 cost sharing with the federal government. Yet now that the Obama administration has proposed an expansion that is a vastly better deal for the state — the feds would pick up 100 percent of the cost for three years, then 90 percent starting in 2021 — Mr. Howell and his colleagues refuse. In the process, they decline to make any proposal of their own that would cover hundreds of thousands of the state’s working poor.

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