But in other states that have a budget surplus, including Georgia, the barriers are political.

Georgia Democratic Rep. Sam Park is among the Democratic lawmakers pushing the state to use some of its billions in surplus funding to make up for the expired subsidies, which he estimates would cost the state $900 million per year. States such as his that never expanded Medicaid, he said, will see hundreds of thousands of people priced out of the individual insurance market with nowhere to turn for coverage.

Georgia Republicans, however, have definitively ruled out using state funding to backfill the disappearing federal aid.