Â鶹ŮÓÅ

More than a dozen states that opted to expand Medicaid under the Affordable Care Act have seen enrollments surge way beyond projections, raising concerns that the added costs will strain their budgets when federal aid is scaled back starting in two years. ... In Kentucky, for example, enrollments during the 2014 fiscal year were more than double the number projected, with almost 311,000 newly eligible residents signing up. That's greater than what was initially predicted through 2021. As a result, the state revised its Medicaid cost estimate from $33 million to $74 million for the 2017 fiscal year. By 2021, those costs could climb to a projected $363 million. (Cassidy, 7/19)

With Alaska Gov. Bill Walker’s decision late last week to unilaterally accept federal funds available to cover low-income people under the Affordable Care Act, three-fifths of all the states have now accepted expanded Medicaid benefits for their residents. Three years after the Supreme Court limited the expansion of Medicaid under President Obama’s health care reform law, the federal-state health program for the poor and disabled has evolved into a troubling dual system in which the availability of health care is being determined largely by the continued partisan divide over Obamacare and the geographic accident of where poor people happen to live. (Pianin, 7/19)