I don't get states not grabbing every Medicaid dime they can

I don't get states not grabbing every Medicaid dime they can.  Maybe 50% (rough guess) of would-have-been-covered patient care will end up being covered anyway but thru increased private insurance premiums or via alternate government channels.  Today's (pre-expansion) Medicaid pays something like 65% back to states – leaving something like (okay, rough guess) 15% profit missed for no reason.  States send this money to Washington in the first place; don't they want it back?  ???

Patients who don’t get care for diabetes, early cancer diagnosis, mental health/drug treatment, not to mention for simply controlling blood pressure and cholesterol are going to show up at the health system in the long run with much more expensive symptoms to treat for which they wont be turned away.  The Republican fiscal version of kicking the can down the road.

Medicaid expansion under Obamacare will pay 90% of costs (100% at first).  Inexplicably, 16 governors resist this money dump in their states.  Florida’s governor wont turn on the spigot because he says he doesn’t trust the feds not to turn it back off.  Wonder what crackpot political party would do something like that.

 
States cut businesses billions in tax breaks hoping to attract jobs.  Medicaid wants to shovel states (back) billions of (their own) dollars -- that will create tens of thousands of good paying medical field jobs (where technical training actually pays off).  Am I missing something here?