As my colleague Patrice Lee documents, new waves of insurance cancellations are hitting because of Obamacare—on top of the millions of cancellations last year.

Just a few weeks ago an American Action Forum analysis also showed that Medicaid expansion hurts job growth and the economy.

A new report from the Government Accountability Office (GAO) now finds that Medicaid and healthcare costs for government employees and retirees will likely double in 50 years. What’s more, by 2060 these program costs will dwarf all other combined state and local government costs. As The Washington Examiner’s Ethan Baron reports:

That will mean less money for police and fire protection, road building and maintenance and public schools.

“To oversimplify it, they basically can do two things: increase taxes or reduce spending,” said GAO’s Director of Strategic Issues, Michelle Sager. “They could do other things, like spending more efficiently or increasing fees.”

The GAO projected the state and local deficits to be about 2 percent of the GDP. By 2060, that number will have doubled. The report also predicted that the governments' deficit against the GDP nearly doubled since last year. In 2013, the deficit was about $167 billion.

The federal government’s deficit was 4 percent of the GDP last year.

“Substantial policy changes” are needed, as “most state and local governments are required to balance” their budgets,” the GAO report said.