Remember Sen Nelson from Nebraska? Tried to broker a deal solely for his state (IIRC) that severely lessened that PPACA-Medicaid bite for each state’s cost-sharing with the Federal Government.
It was KNOWN back in 2009 that the uninsured would be shifted to Medicaid, and half of that cost would be carried by the individual states.
You bet it was known. NY pols knew it, too. And didn’t give a damn.