A new analysis (see below) from the Paragon Health Institute finds that nearly half of Affordable Care Act Medicaid expansion enrollees in 2024—approximately 9.2 million people—were likely ineligible under federal rules, imposing a net federal cost of $32.9 billion that year. California accounted for a disproportionate share: an estimated 3.1 million improper enrollees, or 62 percent of the state’s expansion population, at a federal cost of $10…