Enrollment in Medicaid under the Affordable Care Act has far surpassed expectations, leaving some conservative governors criticizing the system that will cost their states more than projected.
According to Politico, more than 12 million people have signed up for Medicaid under Obamacare since January 2014, in some cases reaching hundreds of thousands more than expected. Seven states, in particular, have had much larger-than-expected surges. By one estimate, the overrun is 1.4 million low-income adults.
The federal government is paying 100 percent of the expansion costs through 2016. That will taper off to 90 percent, leaving additional costs to states that could be too large to absorb, something that a number of governors had long warned.
"The expansion of Obamacare will cost our state taxpayers $5 billion," Florida GOP Gov. Rick Scott told Politico, referring to a 10-year projection.
"Name the healthcare program — I think the only one is Medicare Part D — that costs less than what they initially anticipated … Historically, if you look at the numbers, with the growth in Medicare costs, Medicaid costs, it's always multiples."
A number of other states also saw huge surges.
In Illinois, nearly 541,000 people had signed up by December, well beyond the 199,000 adults the state had estimated would enroll in 2014. By April, the numbers increased to nearly 634,000.
In Washington, 535,000 people had signed up as of March, surpassing the state's January 2018 expectations. The projection for March had been just 190,365 newly eligible enrollees.
In Michigan, where the first-year enrollment projection was 323,000 people, sign-ups surged to 605,000 before falling back to 582,000 earlier this month.
In Kentucky, 311,000 new adults signed up by the end of its 2014 fiscal year, more than double its initial projection of 148,000.
And in February 2014, Minnesota had projected that 147,000 newly eligible adults would enroll by December, but actual enrollment that month was at nearly 194,000.
Obamacare supporters point to the surge in enrollment as a sign of success of the federal healthcare program, meeting the objective of insuring the uninsured. They also suggest that it produces significant health and economic benefits that will outweigh the costs, Politico reported.
But concerns about costs are top of mind for most leaders.
"If you're spending twice as much on this program than expected, that's twice as much money that's being added to the national debt," Nicholas Horton of the Foundation for Government Accountability told Politico.
Even if the states don't pay nearly as much as the federal government for Medicaid expansion, he said, "You're still going to spend more money overall. That's still taxpayer money."
© 2025 Newsmax. All rights reserved.