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The House health care bill would require many states that expanded Medicaid under the Affordable Care Act to pay much more for their newly eligible enrollees beginning in 2020. Here's what it would look like, based on projections from Republican Sen. Bill Cassidy's office:

Expand chart
Data: Government Accountability Office data analyzed by Sen. Bill Cassidy's office; Table: Andrew Witherspoon / Axios

Why states would have to spend so much more:

  • For newly eligible people who sign up before 2020, the federal government will keep paying for 90 percent of their costs — the higher matching rate under the Affordable Care Act.
  • But if they sign up starting in 2020, they only get the state's regular matching rate. In California, for example, this is 50 percent.
  • So the state goes from paying 10 percent of that person's costs under the ACA to paying 50 percent of his or her costs.
  • Massachusetts, Vermont and Montana also expanded Medicaid, but they've been left off of this list. Massachusetts and Vermont already had generous state Medicaid laws, so the ACA treated them differently. Montana expanded late, so data was unavailable.
  • These projections are based on 2016 spending. They don't account for variables like changes in the population or increased medical spending.

Go deeper

Updated 1 hour ago - Technology

Twitter sues Texas AG Ken Paxton

Texas Attorney General Ken Paxton at February's Conservative Political Action Conference in Orlando, Florida. Photo: Joe Raedle/Getty Images

Twitter on Monday filed a lawsuit against Texas Attorney General Ken Paxton (R), saying that his office launched an investigation into the social media giant because it banned former President Trump from its platform.

Driving the news: Twitter is seeking to halt an investigation launched by Paxton into moderation practices by Big Tech firms including Twitter for what he called "the seemingly coordinated de-platforming of the President," days after they banned him following the Jan. 6 Capitol insurrection.

6 hours ago - Politics & Policy

Senate retirements could attract GOP troublemakers

Sen. Roy Blunt (R-Mo.). Photo: Jim Lo Scalzo/EPA/Bloomberg via Getty Images

Sen. Roy Blunt's retirement highlights the twin challenge facing Senate Republicans: finding good replacement candidates and avoiding a pathway for potential troublemakers to join their ranks.

Why it matters: While the midterm elections are supposed to be a boon to the party out of power, the recent run of retirements — which may not be over — is upending that assumption for the GOP in 2022.

Congressional diversity growing - slowly

Data: Brookings Institution and Pew Research Center; Note: No data on Native Americans in Congress before the 107th Congress; Chart: Danielle Alberti/Axios

The number of non-white senators and House members in the 535-seat Congress has been growing steadily in the past several decades — but representation largely lags behind the overall U.S. population.

Why it matters: Non-whites find it harder to break into the power system because of structural barriers such as the need to quit a job to campaign full time for office, as Axios reported in its latest Hard Truths Deep Dive.

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