The single largest increase by far in the Senate budget plan is an additional $584 million dollars plowed into Medicaid in the upcoming year. Next year, the increase will be $796 million.

The Arizona Senate began a final sprint to adjournment Wednesday as a committee debated 10 bills that provide $8.8 billion to fund education, health and welfare, and expansion of Medicaid.

While the debate about Medicaid expansion continues on in several states, a recent study reveals that new beneficiaries may use their new health coverage more often, but won't actually be much healthier because of it.

Closing the gap to achieve fiscal balance over 50 years will require "action to be taken today and maintained for each year equivalent to a 14.2 percent reduction in the state and local government sector's current expenditures." 

State and local governments can expect ever-widening budget gaps through 2060, as rising healthcare costs for both citizens and public employees surpass recent improvements in their revenue, the Government Accountability Office said on Monday.

In the wake of a 2012 Supreme Court ruling, states face complex decisions con cerning whether to expand Medicaid coverage as specified in the Affordable Care Act (ACA). With the federal government no longer able to coerce expansion, states must base their decisions on subjective value judgments that will vary from state to state, incorporating each state's unique budgetary circumstances, the needs of its uninsured population, and the incentives established by interactions between the ACA's provisions. A first important consideration is that states face substantial near-term Medicaid cost increases irrespective of coverage expansion decisions.

Was the slow recovery of the U.S. economy from the trough of the Great Recession anticipated? 

Alternative views on the problem the United States is facing: financing retirement consumption as its population ages.

The Patient Protection and Affordable Care Act (PPACA), signed into law on March 23, 2010, made significant changes to the way eligibility for the Medicaid program will be determined and who the program will cover. State governments will play a key role in implementing many aspects of this reform, which must be in place by the beginning of 2014. States will need to address the financial implications of implementing this Medicaid expansion and accompanying enrollment systems.

State finances are not transparent and often include hidden liabilities as well as rapidly growing responsibilities which are difficult to control.  While state revenues are gradually recovering from the drastic decline of the Great Recession, they are not growing sufficiently to keep pace with the spending required by Medicaid costs, pensions, and other responsibilities and obligations.  This has resulted in persistent and growing structural deficits in many states which threaten their fiscal sustainability.

Three Things to Fix Health Care Now:

#1: Reject the Health Insurance Exchange
#2: Don't Expand Medicaid
#3: Offer an Alternative

This paper examines the ongoing fiscal crisis caused by health-care plans for retirees (known as "other post-employment benefits," or OPEB) in one of the hardest-hit states, California, and outlines necessary reforms that should come before tax increases or cuts to government services.

Supporters of Obamacare claim that expanding Medicaid will entail little to no cost to state governments, since the federal government will fund the vast majority of the additional costs. Indeed, some analyses project states achieving savings from adopting the expansion. However, state lawmakers should be wary of accepting such analyses at face value.

Block-granting Medicaid is the best way to deliver better, cost-effective care to the most vulnerable Americans.

With some reasonable reforms to the program to make the State Health Plan benefits more closely aligned with those offered in the private sector and other state governments, however, the state can put the State Health Plan back onto a sustainable path.