How much will states have to spend to implement the Medicaid expansion mandated by Obamacare? According to a new report released by Sen. Orrin Hatch (R., Utah), the top Republican on the Senate Finance Committee, and Rep. Fred Upton (R., Mich.), head of the House Energy and Commerce Committee, states will spend at least $118 billion through 2023 to cover the expansion.

Obamacare does help the states with funding in the early years, but the Medicaid expansion soon becomes just another unfunded mandate. From the report (emphasis in original):

The massive increases in new federal spending under the health care law did not include the new Medicaid state spending mandates; and American taxpayers are still discovering the extent of PPACA’s costs. In 2017, state governments will be forced to spend new money on expanded Medicaid populations, and by 2020, the states will shoulder these new costs fully. The non-partisan Congressional Budget Office (CBO) originally estimated new state spending on Medicaid at $20 billion between 2017 and 2019, and an independent report from the Kaiser Commission on Medicaid and the Uninsured found that new state spending would be even higher at $43.2 billion through 2019. More recently, CBO has estimated a $60 billion cost to the states through 2021. …

This report conservatively estimates that PPACA will cost state taxpayers at least $118.04 billion through 2023.

The state-by-state findings9 of this report indicate just how unrealistic PPACA’s Medicaid mandates are for the states. California will spend at least another $19.4 billion on Medicaid; perhaps that is why former Governor Schwarzenegger said, “It is not reform to push more costs on states that are already struggling … and this bill … is a disaster for California…” The Texas Health and Human Services Commission estimated that Texas alone will be forced to spend $27 billion—more than the program’s entire annual budget today. The state of Idaho found that the law would grow its Medicaid program by nearly 50 percent. With $675 million in new costs for his state, it is not surprising that Governor Beshear (D-KY) recently said, “I have no idea how we’re going to pay for it.” Finally, former Governor Bredesen (D-TN) noted reality: “I can’t think of a worse time for this bill to be coming … nobody’s going to put their state into bankruptcy or their education system in the tank for it.”

Just another fun surprise cost in Pelosi’s you-have-to-passread-it-to-know-what’s-in-it bill.

Correction: I originally identified Hatch as head of the Senate Finance Committee, not the top Republican.