The election is over and the Affordable Care Act is presumably going to stick around. Advocates and health-care providers are getting antsy as they wait for some decisions about the health law's implementation on the state level.

One of the biggest  questions is whether Govs. Tom Corbett and Chris Christie will opt to expand Medicaid in Pennsylvania and New Jersey.

Estimates put the number of those newly eligible in the half-million range for both states, and hospitals have an investment in the bottom line.

The law was written under the assumption that more people would be covered, said University of Pennsylvania health policy professor David Grande, and was partly financed by pay cuts to hospitals.

"Hospitals agreed to that because they knew that insurance coverage would increase, and that was meant to keep them financially whole," Grande said. "If a state decides not to expand their Medicaid program, then the math starts to not add up so well for hospitals."

Neither Corbett nor Christie is giving a time frame for a decision to be made.

Pennsylvania Health Access Network director Antoinette Kraus is among some of the advocates who are ramping up efforts to lobby for the expansion now that the election is decided.

"The election has made it clear that the Affordable Care Act is here to stay," Kraus said. "And we really need to move forward with implementation now in the state of Pennsylvania. "

The Supreme Court decision regarding the federal health law allows states to opt in or out of an expanded Medicaid program.

Pennsylvania Department of Public Welfare officials wrote a letter to the federal government in August asking for clarification on eligibility and cost criteria for the new program.

They say they are waiting to move forward with the decision process until they get answers back.