However, state Medicaid directors expect the recession's impact to linger, even as the economy improves. The phase-out of enhanced federal assistance will boost the state's share of Medicaid costs in FY 2012 by 25% or more in some cases, the survey found. In addition, directors are facing the expense of preparing for Medicaid expansion under health reform in 2014, when nearly all individuals with incomes below 133% of the federal poverty level will become eligible. A third KCMU report provides a look at efforts to prepare for reform in five states—Connecticut, Michigan, Massachusetts, North Carolina, and Washington. The 14-page report notes that expected leadership transitions—37 states are holding gubernatorial elections in 2010—will lead to replacement of many of the political appointees who are currently spearheading implementation of reform. In addition, Medicaid directors are faced with an aging workforce, constraints on hiring, and the toll from the recession, and they cited particular concerns about the need for more staff and outside contractors to help design insurance exchanges, handle expanded enrollment for Medicaid and the exchanges, and update eligibility systems in the time frame required under the reform law.