The most obvious example were the 10 States which refused to accept increased Federal funding for Medicaid that was made available with the passage of the ACA, which seems largely ideologically driven.

Otherwise the situation is more complex than the original comment suggests, and I can only speak to one state (Idaho), but I don't think the scenario is uncommon in other GOP controlled states and isn't limited to Medicaid.

Idaho has cut taxes in the state for five consecutive years, largely (IMO) on an ideological basis. This had the result, desired by many in a deeply conservative legislature, of creating budget deficits. Even the GOP is normally wary of espousing cuts directly to the state's contribution to Medicaid, but the deficit gives them cover to reduce funding and introduce barriers to service like caps on authorized services and new work requirements. Even when revenues were higher than expected for FY 2026, the governor's office had to act to actually retain those unexpected revenues as it was pretty clear that the Legislature was going to look to claw them back and continue drive down State spending. It's worth noting that health services, including Medicaid funding, represent about a third of the State's budget and their largest portion of the budget.

This whole process has been playing out in public education funding in the State for years as well. Coincidentally, charter school enrollment has increased by roughly 35% over the same 2021 - 2026 period.

Attacking a policy, program or institution financially and then pointing to the deficiencies of those same programs to further fuel funding and efficacy reductions is a pretty well established tactic in US politics as I'm sure it is elsewhere.