Well, what did people think would happen when the federal government mandated a massive expansion of Medicaid?  The GOP claims today [see updates below] that the bill will come to twice as much as first estimated, hammering state budgets already in crisis mode now:

President Obama’s health care law will cost state taxpayers at least $118.04 billion through 2023, about twice the Congressional Budget Office estimate of $60 billion through 2021, Republican members of Congress said today. …

“Governors of both political parties were clear when Congress was debating the $2.6 trillion health law that they could not afford a massive expansion in Medicaid. Washington didn’t listen and plowed forward instead by putting 16 million Americans onto the Medicaid rolls to keep the federal price tag down,” said Hatch. “With this report, we see the true cost to states, who are already facing a collective $175 billion budget shortfall, of this unsustainable expansion.[“]

This has long been the dirty little secret of ObamaCare.  While Barack Obama and Democrats in Congress promised health-insurance coverage for everyone without expanding the federal deficit, the programs burdened the states with mandates to expand Medicaid to cover the now-uninsured.  Ben Nelson got his Cornhusker Kickback to protect Nebraska from the financial hardship of those mandates for a few years, but otherwise Obama and the Democrats left states holding the bag for their new entitlement program.

For taxpayers, increased public costs hurt when they occur at any level.  Pushing the costs onto states may have helped Nancy Pelosi and Harry Reid look better, but the program will still far outstrip its revenue when viewed comprehensively — even without the “doc fix” that changed the reimbursement schedules on which ObamaCare’s financials were built.  States will have to either hike taxes or cut their own spending to accommodate the federal mandate, which will put nearly every governor in the spot currently occupied by Scott Walker in Wisconsin at the moment, even if they don’t arrive there on their own.

There is no such thing as “free” health insurance coverage, nor unlimited public resources.  Eventually, taxpayers will pay for ObamaCare through massive tax hikes, massive reductions in other services, or both, at the state and federal levels.  The only way to avoid it is to dump ObamaCare altogether to save the states and to start over on health-sector reform by using real pricing signals to force consumers to make intelligent choices.

Update: Reader Cory M makes a good point by e-mail, which is that the Republicans reported this result from the CBO, not that the CBO has publicly issued this analysis.  The National Journal report does say that; I misunderstood it when I first read it.  I’ve corrected the headline and inserted a note to see this update at the top.

Update II: Reader and reporter Avi Selk of the Dallas News also points out that the data on which the GOP relied came from many sources, and not just the CBO or primarily the CBO.  I’ve corrected the first paragraph accordingly.