Just a few months ago, few would have predicted that John Kasich would be one of the last three candidates standing in the GOP presidential primary. Now, a lot of GOP voters are looking at Kasich with fresh eyes and considering voting for him.

However, that's not an easy decision for a lot of principled conservatives. Kasich expanded Obamacare in Ohio, and on top of the law being broadly unpopular with the American electorate, it's particularly unpopular with Republican voters. But given that the GOP frontrunner has repeatedly praised socialized health care, you'd think Kasich's policy transgression could be overlooked.

Unfortunately, Kasich is making that very, very hard to do. As we saw last night at CNN's town hall, he sanctimoniously keeps insisting that expanding Medicaid in Ohio to get his hands on Obamacare money was the right thing to do, and he portrayed it as a smart fiscal decision. The former assertion is highly debatable, and the latter is utterly delusional. Here's the transcript of Kasich explaining himself on CNN [I've abbreviated it a bit to make it more germane]:

QUESTION: Hi, governor. In Ohio you accepted Medicaid expansion and you took on the - I'm sorry, the health care exchanges and it was to help the poor. Here in Wisconsin we used - Governor Walker used BadgerCare to essentially provide the same services at the same levels, and yet we did it without creating a whole new entitlement program and expanding federal debt. Why did you choose Obamacare? Why did you choose the Washington-based solution? And why can't you guys ever look at some other source other than Washington for these solutions? KASICH: Okay, let me say a couple of things. First of all, it's not so simple what Governor Walker did here. If you look at it, it's more complicated. … But look, I took a Medicaid program that was growing at 10 1/2 percent, and in my second year as governor it grew at 2 1/2 percent, without taking one person off the rolls or cutting one benefit. How did I do it? I brought innovation to the system. Now I then had a choice. Now that my program was under control, I then had a choice. Could I bring money back, which is frankly our money, Ohio money, back to Ohio to solve some of our problems. Let me tell what you we've done. I don't believe the mentally ill ought to be sleeping under a bridge or living in prison. It costs $22,500 a year to put them in prison. If I can get their medication and get them on their feet and if they can get a job, they become taxpayers. We save money. Secondly, I believe that the drug addicted in our prisons should be treated, because we don't want a revolving door of in and out of the prisons, because that costs $22,500 a year, and we also are throwing a life down the drain. So guess what, because of our program now in the prisons and with the community, we have an 80 percent success rate in not having people go back in, and our recidivism rate is 27 percent. And, by the way, we're running a $2 billion surplus. We don't put our budget together with scotch tape and bail and wire - we're running a $2 billion surplus. We're managing it all. So where are we? Where we are in Ohio, is we are now treating the mentally ill, the drug addicted, the working poor, they're in a better position, they're not in our prisons, and at the same time, they're getting on their feet, they're becoming taxpayers and our Medicaid program is completely under control. … So the idea of doing that was not only compassionate, but it also made good economic sense for our state and it's working out quite well.

Now let's delve into why Kasich's representation of what he did is objectionable. It's not just that he expanded Obamacare. In order to do that, Kasich had to do an end run around the GOP-controlled legislature in his own state to expand Medicaid and get access to the corresponding federal Obamacare money to support the move. Kasich got the Medicaid expansion approved through some questionable maneuvering involving the state's controlling board.

Now let's be clear here. Medicaid is a terrible program. It's doing an extremely bad job of getting medical care for the poor, because Medicaid controls costs by continually ratcheting down the reimbursement rates paid to doctors. Only 45 percent of doctors were accepting Medicaid in 2014 -- down 10 percent from 2009. It's not uncommon for Medicaid patients in urban areas to wait months for basic doctor's appointments.

As a result, health care outcomes for people on Medicaid are often shown to be worse than actually being uninsured:

That's because extensive research indicates that Medicaid recipients actually do worse than people without any insurance at all. A University of Virginia study found that Medicaid patients hospitalized for major surgery were actually 13% more likely to die in the hospital than those without any health insurance. Likewise, the National Cancer Institute found that late-stage prostate cancer, late-stage breast cancer, and late-stage melanoma were actually much more common in Medicaid recipients than in the uninsured. And a Johns Hopkins study of patients receiving lung transplants found that Medicaid patients were 29% more likely to die within three years. What's more, a University of Pennsylvania study (published in the journal Cancer) found that colon cancer patients with Medicaid had a higher mortality rate than uninsured patients, and a higher rate of surgical complications. And these findings hold up even when you correct for age and socioeconomic status. Why Medicaid recipients do worse isn't entirely clear, but it's likely because the best doctors seldom accept Medicaid, leaving patients with subpar physicians.

So as the town hall questioner was right to point out, looking toward Washington for a federal program to actually get the poor health care, as opposed to crappy insurance most doctors don't accept, is a bad idea. If you were a governor claiming to be a fiscally minded policy guy, you might look at a program to get the poor health care that actually works. That program is not Medicaid.

As for the fiscal part of the equation, Kasich's blather about bringing "innovation to the system" and rates of increase seems transparently designed to distract voters from the fact that Ohio's Medicaid expansion is a financial disaster in the making.

Kasich keeps bragging about Ohio's $2 billion budget surplus, but he's going to need it to pay for the Medicaid expansion. In two years, the Medicaid expansion in Ohio cost $7 billion , and the program is on track to double the original fiscal projections by 2020. There's absolutely no rational argument to support Kasich's absurd assertion "our Medicaid program is completely under control."

Which brings us to Kasich's other rationale for expanding Medicaid -- it brought in $14 billion in federal largesse to pay for the expansion. The country is $19 trillion in debt, and while the Ohio governor might want to care for Ohio's poor, that Medicaid expansion is being paid for with federal deficit spending that inevitably burdens taxpayers in other states who have their own poor citizens to take care of.

Finally, and this is what many people find especially galling, Kasich keeps framing his decision as a matter of compassion. At a later question in the same town hall, Kasich cites the Obamacare expansion as an example of "moral courage in the face of public opposition." The clear implication is that those who oppose Kasich's decision just don't care about the poor as much as he does.

He's been pretty explicit about this and has invoked his faith to defend it.

"Now, 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," he said, defending the Medicaid expansion. "But he is going to ask you what you did for the poor. You better have a good answer. "

Invoking Christianity to justify supporting a failing federal program with money you don't have is downright offensive. (And it's especially baffling because Kasich has an extremely narrow view of religious liberty; Kasich's Jesus would compel you to pay for Medicaid and force you to bake gay wedding cakes.)

In sum, the basic facts make Kasich's Obamacare expansion unsupportable on the grounds of effective policy, fiscal responsibility, and moral authority. It's possibly the most liberal position ever articulated and defended by a major GOP presidential candidate in the last several decades.

If Romney's proto-Obamacare health care plan in Massachusetts was disqualifying in the eyes of many conservative voters and that lack of enthusiasm hurt him as a candidate, this is much, much worse. Romney at least tried to spin what he did as being amenable to conservatives. Kasich appears to be doubling down every chance he gets. I don't see a scenario where more scrutiny is brought to bear on what Kasich did and it doesn't end up turning off the same Republican voters he needs to court.