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In the midst of last year’s health care debate, President Barack Obama said, “Everybody out there who talks about deficits has to acknowledge that the single biggest driver of our deficits is health care spending.”

I agree. Health care costs pose significant fiscal challenges at all levels of government. The problem, however, is that the president’s health care overhaul has made Ohio’s budget situation worse. Obamacare doubles down on the same programs that have wreaked havoc on our state’s budget for decades.

Forty-six years ago, Medicaid was created to provide the least fortunate Americans with access to medical care. The program is state-managed, though largely subsidized by the federal government.

Over the years, Medicaid spending has skyrocketed. The federal government spent $346 billion in 2009, up from $187 billion in 2000. This is in line with Ohio’s spending, where “a typical household of four in Ohio pays approximately $2,000 to finance the state Medicaid program, up from under $600 in 1990,” according to a recent Buckeye Institute study.

The new law amplifies this trend — and robs us of the tools that could fix it.

Starting in 2014, states will be required to expand Medicaid coverage to individuals and families with incomes up to 138 percent of the federal poverty level. The mandate essentially forces Ohio to enroll an estimated 554,000 additional beneficiaries to its Medicaid rolls. Many new beneficiaries are likely to be people who do not need the assistance, but whose employers may have stopped providing health insurance once they realize coverage could be provided courtesy of taxpayers.

This drastic increase in participation could place an onerous burden on Ohio’s budget. We already face a shortfall that could exceed $8 billion in the next two years.

The law prohibits states from changing eligibility requirements, cutting reimbursements or reducing benefits, which would allow our state to live within its means. Obamacare expects us to provide additional coverage by spending recklessly.

If Ohio tries to restrict Medicaid eligibility, a provision in Obamacare strips states of any federal financial support. In fact, states are already subject to such a rule under a federal matching requirement passed in the 2009 stimulus — which is set to expire on June 30.

When the federal match expires, state Medicaid spending will have to increase more than 40 percent above last year, according to the Office of the Actuary at the Center for Medicare and Medicaid Services.

Unless this law is repealed, Ohio will have an unfunded mandate likely to put the state further underwater, just as we have begun to revitalize our economy and emerge from our imperiled budget situation.

The Urban Institute estimates that, between 2014 and 2019, Ohio will spend between $830 million and $1.34 billion on Medicaid. At the federal level, in the first 10 years alone, it will cost over $2.7 trillion and add more than $823 billion to the national debt.

All this creates significant problems for state and federal policymakers concerned with fiscal responsibility and economic growth. The president’s concern about health care costs driving deficits is correct but his belief that more government mandates and increased spending is the solution is dead wrong.

Hoisting a one-size-fits-all health care approach onto our state’s and country’s balance sheets leave no one better off. The president has signaled a willingness to permit states to deviate from his singular approach. But whether or not this comes to fruition – and how flexible it will be – has yet to be seen. There does not seem to be evidence the changes will be enough to allow states to escape the budget constraints they currently face.

To paraphrase Justice Louis Brandeis, the true genius of the American system is that states are supposed to serve as laboratories to experiment with different policies, unfettered by federal meddling.

The best way to serve America’s needy and restore fiscal sanity is for Washington to let states have the flexibility to be innovative, figuring out the best practices that cure our heath care troubles.