Recent media reports indicate that a number of states are considering opting out of the Medicaid expansion called for under the Affordable Care Act (ACA). In accordance with the majority opinion of the Supreme Court decision that held the Medicaid expansion provision of the ACA to be an optional rather than a mandatory program, the governors of Florida, Iowa, Louisiana, and South Carolina have signaled that they will seek to opt out of expanding the program. Apparently, a number of other states including Texas already have given similar indications, citing budgetary concerns, despite the federal monetary benefits that accompany the expansion. Statements from some officials at the U.S. Department of Health and Human Services (DHHS) indicate a belief that states will generally want to take advantage of the favorable FFP provisions of the expansion, noting that there was a delay by some states to take part in the Children’s Health Insurance Program (CHIP), when that program began, before joining in. Five states –California, Connecticut, Minnesota, New Jersey, and Washington – as well as the District of Columbia have indicated intent to carry out the expansion.