States are now facing the financial consequences of expanding medicaid. This will start eating into education spending.
The federal government has been picking up the entire tab for the new enrollees, but states will begin paying a 5 percent share in January, and that will rise to 10 percent by 2020.
While that may not sound like a lot, it can add up to tens of millions of dollars per state. Health care is already the second-biggest state expense, behind public schools, and a number of states have yet to see their tax revenue fully rebound from the Great Recession.
In Ohio, nearly 715,000 people had enrolled under the expansion as of August, way beyond the original estimates of roughly 447,000 by fiscal year 2020. Ohio ended up budgeting more than double the $55.5 million it estimated the new enrollees would cost in the coming fiscal year.