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The recent U.S. Supreme Court decision that upheld the Affordable Care Act made the Medicaid eligibility expansion in the law optional for states. As a result, governors and state legislatures across the country are attempting to understand how the expansion would affect the size and cost of their Medicaid programs. This brief is intended to help Kansas policymakers answer those questions and others, such as how much Medicaid costs may rise even if they choose not to implement the expansion.