West Virginia Gov. Earl Ray Tomblin knows the answer to a question he has asked in a letter to U.S. Secretary of Health and Human Services Kathleen Sebelius.
Tomblin and legislators are considering whether to expand the state's Medicaid program dramatically, as required by the new national health care law.
Last week the governor wrote to Sebelius, asking several questions about the matter. One is whether the state can count on federal promises to pay for most of the cost of a bigger Medicaid system.
Of course not.
Tomblin and lawmakers know that from experience with the existing Medicaid program.
Like other federal entitlements, Medicaid, when created in 1965, was supposed to be a limited plan not burdening the states.
By this year, Medicaid was costing West Virginia taxpayers $850 million a year. And the state's share of program costs was scheduled to increase.
So much for the value of promises made in Washington.