The House version of Ohio’s next budget includes one redeeming measure: It continues Gov. John Kasich’s highly successful Medicaid expansion, despite grumbling from Tea Party extremists who care more about rigid anti-government ideology than they do about results.

Even so, the House budget includes onerous changes to the state’s Medicaid program: caps on care, higher costs for the poorest families, bureaucratic hurdles that would lead to dangerous delays and gaps in health care, and a murky plan to force recipients, regardless of income, to contribute to health savings accounts.

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These changes and others would force the state to seek numerous waivers of federal Medicaid rules and give the General Assembly, instead of the governor, the authority to decide who qualifies for Medicaid. As analyst Wendy Patton of Policy Matters Ohio points out, the House budget would create unacceptable barriers to care and undermine the health and medical goals of the Affordable Care Act, including controlling the costs of untreated diseases.

Mr. Kasich must stand up to lawmakers who would undermine Ohio Medicaid, even if that means exercising his veto powers or, once again, sidestepping the legislature and taking Medicaid expansion through the state Controlling Board. His national reputation as a pragmatic moderate depends on maintaining a successful health-care program that has not shown major structural problems.

Ohio’s Medicaid expansion, in raising eligibility to those who earn as much as 138 percent of the federal poverty level, has extended health-care coverage to 500,000 low-income adults and pumped billions of federal dollars into this state’s economy. Without it, the state would lose nearly $10 billion in Medicaid funds over the next two years, as well as an estimated 30,000 jobs and more than $1 billion in expected tax revenue.

Far worse, nearly a half-million Ohioans would lose their federal-state health insurance of last resort. A sicker Ohio would provide less preventive care and suffer more uncompensated and costly emergency-room care.

In the real world, which excludes Ohio’s Statehouse, the debate over Medicaid is no longer between left and right, liberal and conservative, Republican and Democrat. It is between those driven by results and those driven by ideology.

Lawmakers have until the end of June to work out a budget plan. Senators would best serve the state by ignoring the House changes on Medicaid and allowing a common-sense maxim to guide them: If it ain’t broke, don’t fix it.

First Published May 3, 2015, 4:00 a.m.