In new research published by the Mercatus Center, I analyze the causes and impact of the much- higher-than-expected enrollment and spending associated with the Affordable Care Act (ACA) Medicaid expansion. Though unpredicted by Washington experts, the results were predictable. The federal government's 100% financing of state spending on expansion enrollees has led states to boost enrollment and create high payment rates. In states that have expanded, enrollment and per enrollee spending are nearly 50% higher than predicted.
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