More than a dozen states that opted to expand Medicaid under the Affordable Care Act have seen enrollments surge way beyond projections.
Those numbers raise concerns that the added costs will strain state budgets when federal aid is scaled back starting in two years.
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Some lawmakers warn that the price of expanding the health care program for poor and lower-income Americans could mean less money available for other state services, including education.
In Kentucky, enrollments during the 2014 fiscal year were more than double the original estimate, with almost 311,000 newly eligible residents signing up. As a result, the state revised its projected Medicaid costs from $33 million to $74 million for the 2017 fiscal year.
Kentucky state Sen. Chris McDaniel says that's a "monstrous hole" to be filled.