Among many other changes to the health care system, the ACA created an expansion of Medicaid – made optional by the Supreme Court in 2012 – funded largely by federal dollars. Thus far, 30 states and the District of Columbia have accepted the Medicaid expansion. And as should be expected, states that expanded the program have seen spending grow much faster than those that didn’t. In a recent report, the Kaiser Family Foundation found that total Medicaid spending grew nearly 18 percent in expansion states, though the state share of growth was relatively low (less than 4 percent). And while health care has remained relatively quiet as a campaign issue, Governors Kasich and Christie – both Republican presidential hopefuls – expanded Medicaid (and both have defended this expansion) in their respective states.

In a significant win for House Speaker John Boehner and congressional Republicans, a federal judge Monday denied a request by the Obama administration to immediately appeal whether the House of Representatives has the legal right to challenge a provision of the Affordable Care Act.

U.S. District Court Judge Rosemary Collyer ruled last month that one part of the challenge could go forward because the House had shown it had the standing necessary to bring the case. Lawyers for the Obama administration — concerned by what they called an unprecedented ruling on the threshold issue of standing — sought to appeal Collyer’s ruling before her court heard arguments on the underlying merits of the case.