Foundations in Ohio award over $200 million in health-focused grants in an average year. These dollars, however, pale in comparison to the investment that extending Medicaid can provide.

This post originally appeared at Cleveland.com.  Update: As of October 21, 2013, the Ohio legislature approved funding for Medicaid expansion in Ohio.

Health insurance marketplaces or exchanges for uninsured working families and individuals to purchase affordable health care will soon open. Community advocates, organizations and others are strategizing on ways to reach uninsured Ohioans who could benefit from the new program which officially begins Oct. 1.

But only those making more than 100 percent of the federal poverty level are eligible for the new federal marketplace. Ohio has chosen to have the federal government run the state’s exchange.

What happens to those who do not qualify for insurance through their employer and are not eligible for the state’s current Medicaid plan, but are living below 100 percent of poverty and therefore are earning $23,050 or less for a family of four? These Ohioans have no coverage options.

We have forgotten the most vulnerable in Ohio.

They are our friends and neighbors who earn wages that do not afford them the “luxury” of health care coverage. We know insured Ohioans are healthier and more productive Ohioans. And Ohio has a choice: There is an insurance option for them. Fill the coverage gap by extending Medicaid insurance. This is a workforce development issue, not an entitlement issue.

For many years, foundations including the Sisters of Charity Foundation of Cleveland, have partnered with government to meet documented community needs. While we are avid supporters of health access initiatives in the community, we are not regular opinion writers. But at this time we cannot remain silent on extending Medicaid insurance coverage to low-income uninsured individuals.

Beyond any grant we could possibly write, extending coverage will improve the health status of Ohioans by providing monumental access to health care.

The Sisters of Charity Foundation of Cleveland has spent more than $32 million since its inception in 1996 to improve the health and well-being of individuals, families, and communities in Northeast Ohio. Statewide, foundations award over $200 million in health-focused grants in an average year. These dollars, however, pale in comparison to the investment that extending Medicaid can provide.

It is estimated that Ohio has 400,000 lower-income individuals (living at and below 138 percent of poverty) that fall through the coverage gap. Gov. John Kasich made the right public-policy decision when he included Medicaid coverage for this population in his most recent budget, but unfortunately the Ohio General Assembly did not agree to it.

The federal government will match 100 percent of the dollars for the first three years of the Medicaid extension, with the federal portion gradually decreasing to 90 percent. The proposal, if adopted, brings significant resources into the state; extending Medicaid coverage would return $13 billion of Ohio taxpayer dollars back to Ohio.

We recognize the concern of opponents who are uncertain if we can sustain this program once the federal match decreases. However, it would be akin to refusing our federal dollars for our infrastructure. Those monies are Ohio taxpayer dollars being returned to the state for a strong transportation infrastructure to ensure economic growth and prosperity. We should have the same expectation to ensure a healthy workforce in Ohio.

Ohio’s Medicaid program has undergone significant transformation in the last three years and is a model for other states given its success in implementing quality improvement and cost efficiency measures.

It’s not too late for Ohio lawmakers to resurrect the plan.

The proposal will have true impact. The U.S. Census Bureau estimates that 23 percent of Ohioans living below 138 percent of poverty have no health insurance.

Having insurance makes a difference for individuals and families, and these benefits are shared by the business community through a strong, healthy workforce. Filling the coverage gap will result in a stronger state economy, which is why a unique and diverse coalition of business chambers, labor, faith groups and the hospital community supports the expansion. Also, extending coverage will increase revenue from sales taxes on managed-care companies and create an economic boost from more jobs; up to an estimated 28,000 new Ohio jobs in health care and other industries are projected.

There is no policy decision that has greater potential to improve health access and therefore improve the health status of Ohioans than that of extending coverage. We commend Kasich for making the choice to extend health coverage to vulnerable populations based on facts and a cost/benefit analysis and not ideology.

We urge Ohio legislators to help elevate Ohio’s working-poor residents, to enable a healthy workforce and thriving economy for the state. The General Assembly must act now to ensure that Ohio can capitalize on this investment. I encourage readers to contact their lawmakers at 1-800-282-0253 or at www.legislature.state.oh.us.

Extending Medicaid insurance is financially and morally right. Adopt the plan.

Susanna H. Krey serves as senior vice president for foundations, outreach ministries and external affairs at the Sisters of Charity Health System. She has been serving as the president of the Sisters of Charity Foundation of Cleveland since 2004.