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Medicaid

Though the federal government provides some Medicaid funds via matching rates, this welfare program has been taking up a larger and larger share of state budgets in recent years. In fact, Medicaid is the largest category of state spending, accounting for 23.6 percent of state budget expenditures according to the National Association of State Budget Officers.  That percentage is likely to increase over time.

Like other welfare programs, this has a dual effect on state budgets during economic downturns because states face an increasing demand for Medicaid services while their revenues to pay for those services decline. Governors in the states are taking different approaches to deal with this problem. SBS President Bob Williams maintains that the Medicaid system needs to be fixed before it is expanded.

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    • POLICY BRIEF: Oklahoma

      Medicaid expansion is the price to shift the balance of federalism

      State Budget Solutions | by Joe Luppino-Esposito | September 25, 2013

      The debate over Medicaid expansion is as much about federalism and the issue of state control as it is about money-because these are ultimately one in the same.

    • POLICY BRIEF: Virginia

      Medicaid Expansion: The Wrong Prescription for Virginia

      State Budget Solutions | by Joe Luppino-Esposito, Bob Williams | August 16, 2013

      Virginia's Medicaid commission is considering expansion, and this report explains some of the current problems with Medicaid coverage, anticipated problems with accepting Medicaid expansion and discuss alternatives and reforms that will better serve Virginians.

    • RESEARCH

      The Affordable Care Action's Optional Medicaid Expansion: Considerations Facing State Governments

      The Mercatus Center | by Charles Blahous | March 5, 2013

      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.

    • RESEARCH

      On Financing Retirement with an Aging Population

      The National Bureau of Economic Research | by Ellen McGrattan & Edward Prescott | February 4, 2013

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

    • RESEARCH

      States' Implementation of the Patient Protection and Affordable Care Act

      U.S. Government Accountability Office | August 1, 2012

      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.

    • SOLUTIONS: Florida

      Three Things You Can Do to Fix Health Care Now

      Foundation for Government Accountability | by Christie Herrera | December 6, 2012

      Three Things to Fix Health Care Now:

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

    • SOLUTIONS

      State Lawmakerís Guide to Evaluating Medicaid Expansion Projections

      The Heritage Foundation | by Edmund F. Haislmaier and Drew Gonshorowski | October 17, 2012

      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.

    • SOLUTIONS

      Medicaid Is BrokenóLet the States Fix It

      The Wall Street Journal | by Paul Howard and Russell Sykes | October 15, 2012

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

    • SOLUTIONS: North Carolina , Florida

      Medicaid Reform

      Civitas Institute | by Brian Balfour | September 12, 2012

      Any serious attempt at state budget reform in North Carolina must include an examination of its Medicaid program. Costs have been soaring, and past cost-containment efforts have proven both insufficient and detrimental to enrollees' access to care. Moreover, Medicaid enrollees are merely passive participants in the program with little or no choices, and at the mercy of the whims of politicians.

    • SOLUTIONS

      Health Care Compact is real way to reform health care system

      by Keli Carender, Shonda Werry | March 26, 2012

      The Health Care Compact is an interstate compact - which is really just "an agreement between two or more states that is consented to by Congress" - that would return the authority and the responsibility to regulate health care back to the member states.

    • HEADLINES: New York

      NY gets federal OK to reinvest $8B in Medicaid savings

      The Albany Times Union | by Claire Hughes | April 15, 2014

      The long-awaited waiver is $2 billion short of what the state had asked for in 2012.

    • BLOG: Missouri, Arkansas

      The Medicaid dividing line

      State Budget Solutions | by Joe Luppino-Esposito | March 31, 2014

      Jefferson City, Missouri and Little Rock, Arkansas are not geographically far apart, but there's a world of difference in how the legislatures meeting in those cities handle medical care for their most vulnerable residents.

    • HEADLINES: Virginia

      Va. counties urge budget adoption; take no stand on Medicaid

      The Richmond Times-Dispatch | by Michael Martz | March 27, 2014

      The association, representing 95 counties, sent a letter to House Speaker William J. Howell that urges the legislature to end a budget stalemate that already has spilled into a special session that threatens to delay passage of a budget at least a month and likely longer.

    • HEADLINES: Missouri

      Mo. House Blocks Medicaid Expansion, Sets Aside $6M For New State Park, While Approving State Budget

      KBIA.com | by Marshall Griffin | March 26, 2014

      House members spent most of Tuesday bringing up amendments they hoped to add on to the FY 2015 budget, including two attempts to expand Medicaid. Both failed.

    • HEADLINES: Virginia

      McAuliffe offers new budget, but House lawmakers aren't buying

      The Washington Post | by Laura Vozzella | March 25, 2014

      Gov. Terry McAuliffe tried to shake up Virginia's deadlocked Medicaid debate Monday by proposing a new budget that would expand the health-care program and shower a projected $225 million in related savings on teachers, state employees, pre-kindergarten programs and other Democratic priorities.

    • HEADLINES: Virginia

      McAuliffe 2-Year Budget to Include Push for Healthcare Expansion

      NBC29.com | March 20, 2014

      Republicans want to pass a budget without healthcare expansion, and consider the issue separately. Democrats say that's not going to happen. And both sides say they're not budging any time soon.

    • HEADLINES: Colorado

      CO State Budget: Balancing Wants and Needs

      Public News Service | March 17, 2014

      Henry Sobanet, director of the Office of State Planning and Budgeting, said that, while things are certainly looking up in terms of state revenue, recovery won't be instantaneous, and he also said it's important the state prepare for another economic downturn in the future.

      said that, while things are certainly looking up in terms of state revenue, recovery won't be instantaneous, and he also said it's important the state prepare for another economic downturn in the future. - See more at: http://www.publicnewsservice.org/2014-03-17/civic-engagement/co-state-budget-balancing-wants-and-needs/a38145-1#sthash.9zhtuF1P.dpufsaid that, while things are certainly looking up in terms of state revenue, recovery won't be instantaneous, and he also said it's important the state prepare for another economic downturn in the future.
      said that, while things are certainly looking up in terms of state revenue, recovery won't be instantaneous, and he also said it's important the state prepare for another economic downturn in the future. - See more at: http://www.publicnewsservice.org/2014-03-17/civic-engagement/co-state-budget-balancing-wants-and-needs/a38145-1#sthash.9zhtuF1P.dpuf
    • HEADLINES: South Dakota

      SD Legislature passes $4.3 billion state budget

      Associated Press | March 17, 2014

      The South Dakota Legislature passed a $4.3 billion spending plan Friday that gives extra state money to teachers, the state’s four technical institutes and some nursing homes and other health care facilities that serve low-income people.

       

    • HEADLINES: Virginia

      State budget impasse makes planning hard for local governments

      WVEC.com | March 12, 2014

      Local governments in Virginia can't plan their budgets until they know how much money they'll receive from the state. That puts fire, police, and schools in limbo.

    • HEADLINES

      Little-Known Health Act Fact: Prison Inmates Are Signing Up

      New York Times | by Erica Goode | March 11, 2014

      In a little-noticed outcome of President Obama’s Affordable Care Act, jails and prisons around the country are beginning to sign up inmates for health insurance under the law, taking advantage of the expansion of Medicaid that allows states to extend coverage to single and childless adults — a major part of the prison population.