The Affordable Care Act is a substantial reform of the U.S. health care insurance system. In the spring of 2013, the RAND Corporation conducted an analysis assessing the budget effects of the expansion of Medicaid on the Commonwealth of Pennsylvania. The analysis was in part based on a specific set of assumptions 1) regarding the application of Pennsylvania⁰́₉s tax code and 2) about expenditures and revenue sources that could have a material impact on the budgetary outcomes. This addendum examines the sensitivity of those findings to alternative assumptions about the state budgetary effects.