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“I don’t want pioneers of outsourcing in the White House. I want somebody who believes in in-sourcing. Let’s bring those jobs back home,” Mr. Obama said at a campaign stop in San Antonio.

The White House Office of Management and Budget didn’t reply to a request for comment on the inspector general’s report late Monday evening.

Medicaid is the federal-state health care program for the poor.

Expanding Medicaid was a major part of Mr. Obama’s health care law, the Affordable Care Act. He intended for more low-income Americans to end up in Medicaid and for others to be eligible to sign up for plans on the health care exchanges, taking advantage of generous subsidies.

But the Supreme Court made it easier for states to opt out of expanding Medicaid, and a number of them — particularly ones led by conservative Republicans — did so.

Mr. Obama and his aides have spent recent months badgering those states to expand their coverage.