Budget chicanery begets more budget chicanery.

About this time in 2010, Democrats were trying every procedural and accounting trick they could conjure to push ObamaCare through a restive Congress. The big hurdles had been overcome, but the final passage was tangled up.

There wouldn’t be a single-payer system, but the government would establish a “marketplace” where people could buy insurance, including the high-risk, unhealthy customers who private companies didn’t want to take on.

The universality of universal coverage was not an offer, but a requirement. The law would mandate that everyone, especially the low-risk younger Americans who often eschewed expensive health insurance, would have to buy a policy or pay a fine. That, the program’s designers figured, would keep markets stable by offsetting losses insurance companies would suffer with the undesirable customers. Two mandates: Insurers would have to cover, and consumers would have to buy.

Compelling the young and healthy to underwrite the coverage of the old and sick might take care of the problem of the hard-to-insure, but that didn’t address the concern for a larger group without insurance. Democrats had spent the 2008 election debating how to cover the millions of individuals and families who wanted coverage and could qualify for it, but couldn’t readily afford it: Working-class Americans with unreliable access to regular care who lived in dread of a catastrophe that would wreck them both physically and financially.

One answer Democrats found was to provide subsidies for individual buyers in the marketplaces through tax credits they could cash in for coverage. But the bigger piece of the puzzle was to dramatically expand Medicaid, turning a welfare program created to provide insurance for the very poor, into something available to the working class: Those making up to 138 percent of the federal poverty level (about $30,000 for a two-person household today).

But Medicaid was already a hugely expensive program. In order to get........

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