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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      Healthcare costs to negate state, local budget improvements

      Yahoo! News | April 30, 2013

      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.

    • HEADLINES: Indiana

      Indiana General Assembly passes state budget, ends legislative session

      The Indianapolis Star | by Mary Beth Schneider and Chris Sikich | April 28, 2013

      gives more than $1 billion to taxpayers over four years through a mixture of corporate, income, inheritance and financial institutions tax cuts. The spending plan includes increased funding for roads, education and child services.

    • HEADLINES: Ohio

      Ohio Internet cafe ban moving forward, but Senate won't consider Medicaid expansion in budget

      The Cleveland Plain Dealer | by Rex Santus | April 25, 2013

      Leaders in the Republican-controlled Ohio Senate said that they won't consider Gov. John Kasich's proposed expansion of Medicaid as part of the state budget. Instead, senators will study Medicaid reforms separately.

    • HEADLINES: Montana

      Legislators, Bullock finalize state budget, spending deal

      The Missoulian | by Mike Dennison | April 24, 2013

      The deal, crammed into an obscure Senate budget bill shortly before 11 p.m. Tuesday, adds another $13.5 million to the state's $10 billion, two-year budget, including $2 million each for the Corrections, Public Health and Human Services, and Commerce departments.

    • HEADLINES: Missouri

      Mo. Senate Passes State Budget, De-Funds DMV, And Defeats Another Medicaid Expansion Attempt

      St. Louis Public Radio | by Marshall Griffin | April 23, 2013

      The roughly $25 billion spending plan still does not include Medicaid expansion, but not for a lack of trying by Democrats.

    • HEADLINES: Nebraska

      Nebraska's Medicaid funding cut now $52 million

      The Sioux City Journal | April 22, 2013

      Nebraska is seeing yet another federal funding cut to Medicaid this year, forcing lawmakers to reduce services or make up the difference with state dollars before they approve a new budget.

    • HEADLINES: Ohio

      Amended budget bill goes to Ohio Senate

      The Columbus Dispatch | by Jim Siegel | April 19, 2013

      Ohio House Republicans aren't moving forward with a Medicaid expansion, but they kept the door open.

    • HEADLINES: Tennessee

      Lawmakers approve Haslam's state budget

      The Tennessean | by Chas Sisk | April 18, 2013

      Tennessee lawmakers approved Gov. Bill Haslam's $32.7 billion budget for the state of Tennessee, including spending increases for government salaries, schools and health care.

    • HEADLINES: Florida

      Florida's Innovative, Consumer-Driven Replacement for Obamacare's Medicaid Expansion

      Forbes | by Avik Roy | April 15, 2013

      two leaders in the Florida House of Representatives, Will Weatherford and Richard Corcoran, unveiled a new proposal to replace the Obamacare Medicaid expansion with a 100-percent state-funded program to give low-income Floridians the money to purchase private, catastrophic health coverage.

    • HEADLINES: Michigan

      5 budget battles to watch as Michigan lawmakers piece together state spending plan | by Tim Martin | April 12, 2013

      There are always stumbling blocks and areas of disagreement that have to be resolved as the budget process advances. This year in Michigan, those topics include funding for roads, health care and education -- among other topics.

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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.


      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.


      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? 


      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.


      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.


      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.


      Total Medicaid Spending, FY2010 | May 8, 2012

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


      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.


      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.


      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.


      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.


      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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