This week, our In Focus section reviews Medicaid spending data collected in the annual CMS-64 report. Specifically, we provide some analysis around the sharp acceleration in Medicaid managed care spending in federal fiscal year (FFY) 2015. This increase reflects the expansion of Medicaid under the ACA which began in January 2014 and a number of managed care implementations/expansions that occurred during the twelve-month period ending September 30, 2015.