. >> reporter: and dr. khan says that's just the people he knows about in northern virginia. >> there are about 150,000 people that are uninsured. the safety net can only accommodate a limited amount of these people. so the rest of them actually go without even basic primary care and a lot of us-- as doctors, not just me but people-- working in emergency rooms, see the effects of that. >> reporter: for the states that decide to opt into the medicaid expansion, here's how it will work: starting in 2014, the federal government will pick up 100% of the cost. in 2017, the government's share starts to ramp down, so that by 2020 moving forward, washington will pay 90% of the tab with states picking up the other 10%. but a number of republican governors are balking at that, saying even 10% could bust their already troubled budgets. virginia's bob mcdonnell hasn't made up his mind about the expansion yet, but like a number of other republican governors, he doesn't like it. >> all the things it was sold on: that it is go