WASHINGTON -- As Ohio officials try to close an $850 million budget hole, the key U.S. Senate health-care overhaul package could cost Ohio $922 million in additional Medicaid spending in the plan's first five years.

The health-care bill, which is expected to win the Senate Finance Committee's approval this week, would add nearly 800,000 Ohio residents to the state's Medicaid roll. The bill would do so by allowing a family of four with an annual income of up to $29,300 to be eligible for Medicaid coverage instead of the current limit of $22,050 for such a family.

The Finance Committee's bill attempts to cushion the burden on states by picking up most of the additional costs in the first five years, from 2014 through 2019. In Ohio's case, the federal government would pay 95 percent of the additional costs; that would amount to $459 million in 2014 alone.

But the National Conference of State Legislatures has estimated that from 2014 through 2019, Ohio would still have to spend an additional $922 million of its own money on Medicaid because of the new federal mandate.

In addition, the Finance Committee does not say whether the federal government would continue to pay 95 percent of the costs for those new Medicaid enrollees after 2019.

Gov. Ted Strickland, a Democrat, generally has supported congressional Democrats' health-care overhaul efforts. He says that once health-care legislation is closer to being complete, he will need to evaluate how it would affect Ohio's Medicaid spending.

Strickland said it is possible that if more state residents are insured, it would be a boost for the state's economy and its budget, which could prove to be a net benefit even if the state's share of Medicaid spending went up.

Still, Strickland warned on a recent visit to Washington that "the states, with our financial challenges right now, are not in a position to accept additional Medicaid responsibilities."

Strickland said that he wants "a health-care package that is inclusive and provides for all citizens," but he added that if Medicaid is expanded, he hopes to "see the federal government assume the greater portion of the costs, if not the total costs."

Medicaid is a joint state-federal program created by Congress in 1965 that pays for health coverage of the poor and for long-term nursing care. The federal government normally finances about 60 percent of the current costs, meaning Ohio pays the rest, but the federal government's stimulus package is supplying extra Medicaid money through 2010.

Ohio pays more than $12 billion a year for Medicaid.

Senate Finance Committee Chairman Max Baucus, D-Mont., is the chief architect of his committee's bill, which is considered the most moderate of the five measures circulating on Capitol Hill -- three in the House, and two in the Senate.

To gain the backing of Senate Majority Leader Harry Reid, D-Nev., Baucus agreed to a revision that would have the federal government finance all the costs of Medicaid expansion to "high-need states" meeting certain criteria. Those states are Michigan, Nevada, Oregon and Rhode Island.

Meghan Dubyak, a spokeswoman for Sen. Sherrod Brown, D-Ohio, said that when the bill reaches the Senate floor, Brown "is going to be fighting to make sure that states like Ohio with high unemployment rates receive an increased share from the federal government," much like Michigan and Nevada.

jtorry@dispatch.com

jriskind@dispatch.com