Republican state lawmakers and Gov. Pat McCrory are taking a principled stand against the expansion of Medicaid because they don’t believe the additional spending by the federal government is sustainable. Nor do they want to receive federal funds with so many strings attached.

But the alternative, which seems well on its way to becoming law, is to leave 500,000 North Carolinians without any form of health care insurance and in turn drive up the price of care for the rest of us at hospitals that will take on the poor as charity cases.

Meanwhile, the federal money that would have come to North Carolina for Medicaid expansion won’t be saved or given back to state taxpayers. It simply will be sent to other states that are on board with so-called Obamacare. Your tax dollars will still go to work – but not in the state in which you live.

And that’s a pretty healthy chunk of change. The federal government would have paid for 100 percent of the Medicaid expansion for the first three years of implementation and 90 percent of the expansion for the following eight years.

A nonpartisan study by the state estimated that accepting the federal money would have allowed health care industries in North Carolina to hire 23,000 additional employees – doctors, pharmaceutical makers and other people to fill jobs with good pay. The economic impact of those new workers was estimated to be about $1.2 billion. Couldn’t we use that kind of expansion in North Carolina?

We applaud McCrory’s pledge to take a hard look at Medicaid management in North Carolina. A recent audit uncovered an obscene number of cost overruns, estimated at $1 billion.

But aside from principle, it’s hard to find a good reason for refusing federal money that is simply going to be spent elsewhere.

North Carolina legislators have missed an opportunity to help the poor – and the rest of us – and add much-needed well paying jobs as a result of their decision.