From California to Rhode Island, states are confronting new concerns that their Medicaid costs will rise as a result of the federal health care law.
That's likely to revive the debate about how federal decisions can saddle states with unanticipated expenses.
Before President Obama's law expanded Medicaid eligibility, millions of people who were already entitled to its safety-net coverage were not enrolled. Those same people are now signing up in unexpectedly high numbers, partly because of publicity about getting insured under the law.
For states red or blue, the catch is that they must use more of their own money to cover this particular group.