SebeliusCHARLESTON - Gov. Earl Ray Tomblin, in a letter to the secretary of the U.S. Department of Health and Human Services, says he wants more information before deciding whether to expand Medicaid in the state. Tomblin, a Democrat, sent a five-page letter with a list of 16 separate questions to Kathleen Sebelius Thursday. "My staff and I have spent the last several weeks analyzing the recent Supreme Court ruling regarding the Patient Protection and Affordable Care Act. We are taking this analysis very seriously and attempting to balance several key factors in determining how to proceed. At this point, we need more information before West Virginia can make the crucial decisions required by the Act," the governor said in a statement. "The decision on whether to expand Medicaid for working West Virginians is significant. "On the one hand, the expansion would cover well over 100,000 hard working West Virginians and would in turn allow them to begin receiving appropriate diagnosis and treatment at a much earlier stage. In a state where heart disease, diabetes and other chronic health conditions occur at levels far too high, this type of access to health care could provide meaningful improvements to the health of our citizens. It also has the potential to reduce health care costs in the future, saving taxpayer dollars and keeping insurance premiums and copays lower," Tomblin said. He continued, "On the other hand, even though the promised federal match rate is very favorable, I must determine whether the State can afford this expansion in the long run. I think we all agree the federal government's current fiscal path is unsustainable." Tomblin said he is "cautious" in relying on the government's "future funding promises." "Before a final decision is made, West Virginia must have a plan for the long-term sustainability of any type of Medicaid expansion. Right now, we don't have the information necessary to make the decision," he explained. To see Tomblin's letter -- and the complete list of questions -- click here. More than two years after President Barack Obama's Patient Protection and Affordable Care Act was signed into law, the U.S. Supreme Court ruled 5-4 that most of it is constitutional. The Court, in its highly-anticipated June 28 opinion, ruled that the controversial provision of the federal health care reform requiring individuals to purchase insurance or face a financial penalty is a constitutional tax. The individual mandate -- the chief issue before the nation's high court -- imposed a $695 annual penalty on individuals who did not purchase health insurance. Obama's own budget director said in February that the mandate was not a tax. "The Affordable Care Act's requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax," Chief Justice John Roberts wrote. "Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness." Roberts was joined in the majority by Obama-appointees Sonia Sotomayor and Elena Kagan, as well as Ruth Bader Ginsburg and Stephen Breyer. Voting against the ACA were justices Anthony Kennedy, Antonin Scalia, Clarence Thomas and Samuel Alito. The Court's opinion also said that if a state does not comply with new eligibility requirements for Medicaid, the states can only lose new funds available instead of all of their funding.