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 that she has emphasized the need to root out fraud, institute a work requirement and include other accountability measures before any cuts.

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. 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.

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.