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Healthcare

States spend more than $200 billion annually for health care for the poor and medically needy, according to the State Budget Crisis Task Force.

Medicaid has taken up a larger share of state budgets in recent years, with the program's expenses totaling approximately one quarter of total state expenditures, according to the National Association of State Budget Officers. This has a dual effect on state budgets during economic downturns, as states face an increasing demand for Medicaid services while the revenue available to pay for those services declines. New York spends $54 billion per year on Medicaid, the most of any state.

The impact of Obamacare on state budgets remains to be seen, and governors have had varied responses to the Supreme Court decision upholding the law which would increase the number of Medicaid enrollees, but not penalize the states that do not participate.

SBS is here to keep you informed and armed with healthcare solutions.

 

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    • HEADLINES: California, Connecticut, Iowa, Kansas, Louisiana, Maryland, New Jersey, New York, North Carolina , Vermont, Virginia, Washington, Wisconsin

      Williams Report - August 19, 2014

      State Budget Solutions | by Bob Williams | August 19, 2014

      Join us on Twitter today by following @StateBudgets and tweeting with the hashtag #SBSBob.

    • HEADLINES: Illinois, Maryland, Minnesota, New Hampshire , North Carolina

      Williams Report - July 7, 2014

      State Budget Solutions | by Bob Williams | July 7, 2014

      We hope you had a great Independence Day weekend! Join us on Twitter today by following @StateBudgets and tweeting with the hashtag #SBSBob.

    • HEADLINES: Illinois, Indiana, Maine , Massachusetts , Michigan, New Jersey, North Carolina , Oklahoma

      Special Edition Williams Report July 2, 2014

      State Budget Solutions | by Bob Williams | July 2, 2014

      Welcome to a special edition of the Williams Report! There has been a lot of news this week: an important U.S.Supreme Court decision on unions and the end of the fiscal year in many states have been in the headlines. Join us on Twitter today by following @StateBudgets and tweeting with the hashtag #SBSBob.

    • HEADLINES: Virginia

      Virginia's budget drama ends; Medicaid expansion on hold

      State Budget Solutions | by Elia Peterson | June 27, 2014

      After a long, drawn out battle in Richmond, Virginia's legislature approved a budget that sidestepped several key vetoes from Governor Terry McAuliffe.

    • HEADLINES: California

      Flabby Obamacare spending: America's Most Outrageous State Spending Proposals

      State Budget Solutions | by Joe Luppino-Esposito | June 26, 2014

      Say “Farewell to Fat” and “Hello” to pork.

    • HEADLINES: California, Indiana, Michigan, New Jersey, North Carolina , Pennsylvania, Washington, Louisiana, Montana, Virginia

      Williams Report - June 23, 2014

      State Budget Solutions | by Bob Williams | June 23, 2014

      The latest news from State Budget Solutions, including commentary from Bob Williams. Tweet #SBSBob to talk about state budget and pension headlines throughout the nation.

    • HEADLINES: Virginia

      GOP has claimed control of Va. Senate, forced Democrats to cave over Medicaid impasse

      Washington Post | by Laura Vozzella and Michael Laris | June 10, 2014

      Virginia Republicans snatched control of the state Senate on Monday, immediately ending a budget stalemate by pushing Democrats to agree to pass a spending plan without Medicaid expansion, Gov. Terry McAuliffe’s top priority.

    • HEADLINES: Ohio

      Midterm budget bill heads to Kasich's desk

      WKBN.com | June 6, 2014

      Final passage came after lawmakers sought to ensure additional legislative control over $300 million set aside in the budget measure for a Medicaid reserve fund. The fund covers unexpected expenses for the taxpayer-funded health program.

    • HEADLINES: Virginia

      Va. Republican offers plan to end Medicaid deadlock

      The Washington Post | by Laura Vozzella | May 30, 2014

      Sen. Emmett W. Hanger's plan asks both sides to give a little, divorcing the Medicaid issue from the budget as opponents want but also remaking a state Medicaid commission so it could no longer block expansion.

    • HEADLINES: Virginia

      Va. officials plan for possible state shutdown

      Associated Press | by Alan Suderman | May 27, 2014

      Some local government officials in Virginia are starting to consider contingency plans for worst case scenarios as a budget impasse drags on toward a possible unprecedented state shutdown on July 1.


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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

      Forecasting the Recovery from the Great Recession: Is This Time Different?

      The National Bureau of Economic Research | by Kathryn Dominguez & Matthew Shapiro | February 4, 2013

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

    • 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.

    • RESEARCH

      State Budget Crisis Task Force Report

      State Budget Crisis Task Force | by Richard Ravitch and Paul Volcker | July 17, 2012

      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.

    • RESEARCH

      Total Medicaid Spending, FY2010

      StateHealthFacts.org | May 8, 2012

      A map and chart ranking Medicaid spending for each of the 50 states in FY2010.

    • RESEARCH

      State and Local Governments' Fiscal Outlook

      In the long term, the decline in the sector's operating balance is primarily driven by the rising health-related costs of state and local expenditures on Medicaid and the cost of health care compensation for state and local government employees and retirees.

    • RESEARCH

      2011 State Employee Health Benefits: Monthly premium costs (family and individual coverage)

      Among the 50 state employee health benefit plans, there is considerable variation in premium rates and in how the costs are shared between the state and employee.The average premium for a standard family policy was $1,377.03, with the state paying an average of $1,096.63 (80 percent) and the employee paying the remainder. (Based on 42 states.) The average premium rate for the lowest cost family insurance option was $1,101.28, with the state paying an average of $974.66 (88 percent).


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    • 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: California

      Reform Before Revenue: How to Fix California's Retiree Health-Care Problem

      The Manhattan Institute | by Stephen D. Eide | October 31, 2012

      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.

    • 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

      State Health Plan for Employees and Retirees Reform

      September 12, 2012

      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.

    • 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: Florida

      A Medicaid Cure: Florida's Medicaid Reform Pilot

      Foundation for Government Accountability | by Tarren Bragdon | May 23, 2012

      During its five years of operations, Florida's Medicaid Reform Pilot has improved the health of enrolled patients, achieved high patient satisfaction, and kept cost increases below average, saving Florida up to $118 million annually.

    • SOLUTIONS: Georgia, North Carolina

      Medicaid Frills Cost NC Billions, but GA May Shy Away from Cuts

      Civitas Institute | by Matt Willoughby | May 23, 2012

      Medicaid services not required by the federal government but approved by the state legislature in years past cost North Carolin $4.4 billion in 2010-2011. That accounted for 46 percent of the state's $10 billion Medicaid budget.

    • SOLUTIONS: Rhode Island, Florida, Idaho, Tennessee, Washington

      The Political Economy of Medicaid Reform: Evidence from Five Reforming States

      Mercatus Center | by Scott Beaulier, Brandon Pizzola | April 26, 2012

      To better understand best practices in Medicaid reform, we explore five recent state-level Medicaid reforms and their ability to simultaneously reduce costs, maintain or increase access, and survive the politics of reform.

    • 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.


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