Elected officials across the country are bracing for proposed cuts to Medicaid as the federal government looks to change the way it spends taxpayer dollars. In West Virginia, Republican U.S. Sen. Shelley Moore Capito is concerned enough about how such cuts would affect her state that she has emphasized the need to root out fraud, institute a work requirement and include other accountability measures before looking to cuts.

But, according to a report by The Commonwealth Fund, Ohio is among the five states that would see the greatest economic losses from cuts to Medicaid funding. California, New York, Texas and Pennsylvania are the others. Authors of the fund’s report say “Medicaid drives employment in the health care sector; generates state and local tax revenue; and saves money for enrollees, allowing them to spend more on items other than health care. … At the same time, reductions in Medicaid funding can negatively impact state tax revenue, employment, and individual spending power.”

Medicaid covers approximately one-quarter of Ohio’s population, according to the Ohio Capital Journal. Approximately 770,000 of those people are covered by the Medicaid expansion to which Ohio signed on in 2014.

Cuts to federal Medicaid spending that have been suggested in a draft budget that now sits in the U.S. House of Representatives would require an approximately 29% increase in state Medicaid spending per resident, should states try to make up the difference.

Last month, the Ohio Medicaid Matters Coalition — including the Ohio Hospital Association, Ohio Association of Foodbanks, Ohio State Medical Association and Ohio School-Based Health Alliance — asked Gov. Mike DeWine to be active in defending the state’s Medicaid benefits. At the time, they said Medicaid is a “critical driving force in fostering thriving communities,” while supporting the preservation of coverage for as many Ohioans as possible, according to a report by The Columbus Dispatch.

Necessary reductions in spending are never easy. Certainly doing things the way they have always been done isn’t going to change anything.

Doing nothing is not the answer. But neither is slashing with reckless abandon and no regard for the human beings who will be harmed.

Capito and others are right that perhaps we should first look at eliminating Medicaid fraud and putting other measures in place to ensure the program is a hand up, rather than a hand out.