THE 200TH day of 2014 happened to fall this weekend. Depending on which figures you prefer, that means Virginia’s refusal to opt into expanded Medicaid since Jan. 1 has cost the state at least $693 million in federal funding. Democrats say it’s an even $1 billion.

No matter how you crunch the numbers — and we are indebted to PolitiFact for crunching them for us — that’s a lot of money to leave on the table.

Those princely sums, which many other states have rushed to capture, would have provided health coverage to some 400,000 currently uninsured Virginians, many of them indigent. It would have cost not one additional dime to Virginia taxpayers, who have already paid for expanding Medicaid in the course of their regular federal tax filings.

The decision to leave those dollars on the table — an amount that increases by at least $3.46 million per day — is the doing of Republicans in the General Assembly. Those sages of Richmond, led by the Speaker of the House of Delegates, William J. Howell (R-Stafford), have proposed no alternative to providing health coverage to the hundreds of thousands of Virginians who lack it, nor any other method of capturing all or part of the federal funds that remain within Virginia’s grasp, should the state opt into the expansion.

Instead, Mr. Howell and the Republican House caucus have elected to play political games, calling for the legislature to reconvene to “debate” Medicaid expansion, which they unequivocally oppose.

The GOP lawmakers purport to explain their stance by fretting that the federal government cannot be trusted to make good on its promise to pay for the entire cost of Medicaid expansion until 2016 and slowly scale down to 90 percent in the years thereafter .

In their prescience, Republicans are convinced that Washington will break its word someday. Rather than expose the state to such deceit in the future, they prefer to spurn the money now and forever.

Never mind that Virginia, as other states, would be free to undo its participation in the expanded program if and when the feds break their word. And never mind, too, that the very same Republican argument could be made about virtually any federal program.

If Mr. Howell and his Republican colleagues adopted the same attitude toward other federal programs as they have for Medicaid expansion, Virginia would instantly tumble into penury. But logic isn’t the point. The point is purely ideological and partisan: to hand a defeat to President Obama and Democratic Gov. Terry McAuliffe.

Richmond’s Republicans have achieved that goal. In the process, they have also handed a defeat to Virginians.