If Indiana expands its Medicaid program as called for under President Obama’s health reform law, it likely will hike state spending on the program an extra 13.5 percent by 2020, according to the latest projections from Seattle-based actuarial firm Milliman Inc.

That means the state would spend $516 million more per year to provide Medicaid health benefits to low-income Hoosiers. And since Medicaid spending—even without the new law—already is projected to grow more than $1 billion between now and 2020, the extra spending would put even more pressure on state finances.