Governor John Kasich, a Tea Party Republican, has included expansion of Medicaid in his biennial budget. That budget must be passed by the Ohio General Assembly, which is dominated by Republicans from safely gerrymandered districts. As we’ve seen in Florida, however, a gubernatorial endorsement is no guarantee that Medicaid expansion will become law.

Advocates for the expansion have organized a diverse coalition, including progressive organizations, hospital associations, chambers of commerce, and Ohio Right to Life (ORTL), which pushes for limiting access to reproductive health care.

Ohio Pro-Life Action (OPLA) and Cincinnati Right to Life (CRTL) are opposing Medicaid expansion. In addition to adding a new level of repugnance to their movement, these decisions are direct challenge to the viability of ORTL.

OPLA came into being to support the Heartbeat Bill, which would have banned abortions after seven weeks. ORTL was opposed to the Heartbeat Bill, which, it was feared, would result in a Supreme Court ruling which would also overturn 20-week bans around the country.

OPLA was formed at the prompting of Cincinnati Right to Life. This is significant because Cincinnati is the home of National Right to Life co-founder Dr. Jack Willke, whose work in the seventies forms the bioethical basis for Todd Akin’s infamous assertion that pregnancies do not result from “legitimate rape.” Not only do Cincinnati Republicans believe Dr. Willke’s quackery, they’re required to repeat it in public. Dr. Willke renounced membership in ORTL over the Heartbeat debacle.

OPLA spent most of last year fundraising through aggressive attacks on ORTL. OPLA is trying to undermine ORTL’s support within the donor community in order to supplant ORTL politically … or at least get rich in the process.

Medicaid presents a new front in this internal struggle. Cincinnati Right to Life levels a simple argument against Medicaid:

1. Hormonal birth control is abortion
2. Medicaid covers birth control
3. Therefore Medicaid covers abortion
4. Abolishing Medicaid will save lives

I don’t know why they stop at the Medicaid expansion. By this logic, all health insurance should be banned.

Somebody should probably tell them that Ohio Medicaid already covers birth control for incomes up to 250 percent of poverty. The Medicaid expansion will have no impact on birth control coverage for low-income Ohioans.

Ohio Pro-Life Action, having learned all the wrong lessons from 2012, takes a different angle. They’re opposed to the Medicaid expansion because Medicaid (theoretically) covers abortion for rape survivors—or, in their alternate reality, women who are lying about having been raped so that they can get Medicaid benefits.

OPLA’s stance leads to the question: if rape can’t result in a pregnancy, why does Medicaid’s abortion coverage doom the program?

They’re both mad that Medicaid can be used for services at Planned Parenthood, like breast cancer screenings. Cash can also be used at Planned Parenthood: The US Treasury sponsors abortion!

Forty percent of births in Ohio are covered by Medicaid. That figure won’t be affected by expansion, but what will happen is that those women will already be enrolled in Medicaid when they become pregnant, so they’ll have access to prenatal care around six months earlier and, at delivery, they’ll have more access to breastfeeding supplies and counseling.

And the infant mortality rate will plummet, all because Ohio expanded Medicaid.

Of course, CRTL could already be availing pregnant women of these resources at their Crisis Pregnancy Centers, but, as shown by NARAL Ohio, they don’t.

The arguments of OPLA and CRTL are grounded in the rhetorical debates of 2012, which were politically disastrous but resulted in huge windfalls for the organizations making them. That makes it likely that OPLA will escalate their attacks whenever ORTL argues in favor of expansion. After all, OPLA has little interest in policy outcomes—they’re more concerned with their status in the donor community.

It is entirely likely that we can get a slew of Ohio legislators publicly saying they oppose the Medicaid expansion because it would make it slightly easier for rape survivors to get coverage for abortion. Or that they oppose Medicaid expansion because birth control exists.

If we get even one legislator to say that on camera, it should become much harder to oppose Medicaid expansion anywhere.