Medicaid spending soared nearly 14 percent last year—its biggest annual increase in at least two decades—as a result of millions of newly eligible low-income enrollees signing up under the Affordable Care Act, according to a report released Thursday by the Kaiser Family Foundation. Total spending was highest in the 29 states that expanded Medicaid, the government insurance program for low-income and disabled people, under the health law. In those states, total Medicaid spending jumped nearly 18 percent in the fiscal year that for most states ended June 30, the Kaiser researchers found. (KHN is an editorially independent program of the foundation). In the other states that did not expand, Medicaid spending rose about 6 percent, the report found.