How sick is this?

The longstanding argument that close to 1 million Floridians could access healthcare if Florida legislators would only agree to expand Medicaid hasn’t worked. Neither has the fact that some legal immigrants earning low incomes can get insurance subsidies that U.S. citizens can’t. And don’t bother playing the human-suffering card. So far, it has fallen on deaf ears.

Perhaps the economic argument will persuade lawmakers to put aside their political opposition to Medicaid expansion, because it is costing their constituents a bundle. In fact, the refusal to accept federal funds, provided by the Affordable Care Act, will over the course of almost 10 years, send billions of Florida taxpayers’ dollars into those states that have wisely decided to broaden Medicaid coverage.

Florida is one of 23 states that have refused to accept federal funds for this purpose. Lawmakers and the governor have cited their opposition to the long arm of Big Government and fears of having to bow down to it. It’s reasonable to posit, too, that its association with Obamacare, considered a scourge in many — but not all — Republican quarters is the fuel running the engine of opposition.

But it’s not as if the wrongheaded decision to reject federal funds means that $51 billion — to be received over a decade — merely has been left on the table. It’s being put to good use — elsewhere. An analysis by McClatchy found that Floridians and their counterparts in 22 other stubborn states, will pay, over the next eight years, $152 billion to expand the Medicaid program in other states, and get no benefits in return. Most of the funds, almost $88 billion, will be provided by just five — Florida, of course, among them. Earlier this year, Julio Fuentes, president and chief executive of the Florida State Hispanic Chamber of Commerce, cited a study that said if Florida had expanded Medicaid starting in January, federal funds coming to the state would have supported more than 71,000 jobs and created $8.9 billion in new economic activity in 2016.

It’s a shame that lawmakers’ allegiance to ideology has trumped their responsibility to act in their constituents’ best interests. They are denying healthcare to hardworking Floridians who, though low-income, still make too much to qualify for Medicaid and too little to qualify for federal tax credits under the ACA.

Medicaid could be expanded to Florida residents with incomes up to 138 percent of the federal poverty level. That’s $27,310 for a family of three. So many of these workers form the under-appreciated backbone of the state’s economy, cleaning hotel rooms, providing daycare, washing dishes in restaurant kitchens. But lawmakers have dismissed their needs. Currently, Florida’s Medicaid program sets an annual income eligibility ceiling of about $6,930 for a family of three, and it doesn’t assist individuals and families without dependent children, no matter how little they earn. They’re in a bind, but their representatives in Tallahassee are content to let the residents of other states — including several with Republican governors, such as Jan Brewer, of Arizona — get healthcare on their dime.

There’s another twisted irony: Florida residents already are footing the bill for the uninsured, who usually wind up in the emergency rooms of publicly funded hospitals when they get sick enough.

Last year, Gov. Rick Scott softened his firm opposition to accepting federal funds to expand Medicaid. But his vocal support during that legislative session was nonexistent, and the expansion was DOA. This campaign season, he needs to answer the question how any of this is good for Florida.