My understanding is that the feds cover Medicaid expansion for the first year (and partially thereafter for a time?), so "could not afford to exp[a]nd Medicaid" is not quite correct - especially in the short term, though it's possible there's something I've missed (is there a requirement the state continue if they start, that hasn't been discussed? or another gotcha somewhere?). Obviously, there's possible political cost to "dropping people from Medicaid" after the one year, but that being worse than keeping them off Medicaid for that year and forward is... human, but strange.