Government spending on Obamacare premiums has raced past its per-person spending on Medicaid expansion, and the gap is poised to increase—a trend that has some policy experts shaking their heads over the long-term economic picture and at least one major insurer questioning the sustainability of the individual market. This year, federal dollars going to exchange premium subsidies more than doubled from 2014 and the Congressional Budget Office projected they will nearly double again over the next decade. States are pursuing reinsurance waivers and even eying further expanding Medicaid—where the federal government shoulders nearly all the cost—through a public option to lower expenses for the people covered through the exchanges. But congressional gridlock over the ACA's future will likely drive the cost trend forward. (Susannah Luthi, Modern Healthcare)