John Kasich, the Republican governor of Ohio, came to Georgia this week to test the waters for a presidential candidacy.

And as usually happens when venturing into red-state-territory, Kasich was asked immediately to justify his decision to expand Medicaid in his state, a decision that extended health coverage to more than a half million lower-income Ohio residents, brought billions of dollars of federal money into his state and helped struggling rural hospitals stay afloat.

And as usual, Kasich was pretty blunt in responding. “My (other) choice in that decision was to ignore some of the most vulnerable people in our population,” he told his fellow Republicans. “I’ve been criticized for this decision. Do you think it bothers me? It doesn’t.”

In other settings, Kasich has been even more provocative. As he told Ohio legislators during debate over Medicaid expansion, “when you die and get to the meeting with St. Peter, he’s probably not going to ask you much about what you did about keeping government small. But he is going to ask you what you did for the poor. You better have a good answer.’”

Nathan Deal, what’s your answer? David Ralston? Casey Cagle?

If that sounds harsh, it was intended to be. Based on the results of a Harvard University study, expanding Medicaid to another 500,000 Georgians would save a projected 2,700 lives each and every year. The basic quality of life for tens of thousands of other Georgians — freedom from pain, freedom of movement, ability to work — would improve significantly with the better access to health care that insurance would bring.

But no. We live in a state with the nation’s second-highest uninsured rate and its highest rate of maternal death, and count it good enough. In 2009, the Commonwealth Fund rated our state’s health care system 35th in the nation. By 2014, just five years later, we had fallen 10 spots to 45th. Why should we change?

Kasich is by no definition a liberal. He opposes gay marriage, has cut taxes as governor and pushed through measures that cut the number of Ohio abortion providers in half. As a member of Congress, he was one of Newt Gingrich’s top lieutenants. But as a son of the working class, he rails against “this growing notion — particularly among those people who have — that those that do not have are somehow lesser.”

In the Medicaid debate, we’re talking people who, in a household of three, make less than $27,724. At that income level, someone may be working full time making $12 an hour, but that kind of job doesn’t offer health insurance as a benefit, nor are such jobs attainable for them anytime soon. They certainly can’t afford to pay for it on their own. Without access to Medicaid, they have no realistic hope of becoming insured.

Last year, Kasich won re-election by 31 percentage points in a state carried twice by Barack Obama. In his second inaugural, he stressed the importance of empathy and compassion, old-fashioned virtues that “make it possible for us to care enough to begin to reach out to those who have been forgotten, disenfranchised, ignored, or who are suffering.”

Maybe I’m wrong, but I suspect that kind of talk makes him unelectable here.

And if so, what does that say about Georgia?