More than half the U.S. states will not have enough revenues to cover spending demands in the fiscal year starting in July.

The Quinn administration released a budget outlook that shows most state operations should expect a 9 percent reduction, which the governor says is needed to help the state pay pension and Medicaid costs which have been on the rise.

When the Florida Legislature convenes for its annual 60-day session on Tuesday, a $2 billion projected budget shortfall and the redrawing of political districts will dominate.

West Virginia lawmakers will have to make some tough choices in coming years if they want to keep the state budget balanced without raising taxes becuse increasing health care costs are putting more and more strain on future state budgets.

Public schools and Medicaid are the biggest budget appropriations in Maryland, but taking the large price-tag items off the table makes it harder for the legislature to find a half-billion dollars to cut from the budget

Attorneys for California's Medi-Cal program are gearing up to appeal two court rulings issued last week that strike down a 10 percent cut to some medical service providers for low-income Californians.

Beginning Sunday, Connecticut will jettison its private health plans from Medicaid, the state-federal health insurance program. Instead of paying the companies a set monthly fee to cover the health costs of more than 400,000 children and parents, the state will assume financial responsibility.

Florida lawmakers head into their annual session in January confronted by a nearly $2 billion gap. This time around it is primarily caused by an unenviable combination of growing expenses in safety net programs such as Medicaid at the same a sluggish economic recovery is expected to keep tax dollars from growing significantly.

Gov. Bob McDonnell's plan would increase spending for state colleges, transportation and economic development and would pump cash into underfunded state employee and teacher pension plans. But it calls for nearly $800 million in targeted savings in specific areas, mostly in Medicaid and public schools.

These days the health program for the poor is claiming a bigger slice of states' spending than even K-12 education, says a report from the National Association of State Budget Officers.  All told, Medicaid is expected to grab 23.6 percent of states' spending in fiscal 2011, up from 22.3 percent the year before.

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.

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.

An examination of Medicaid spending by state over a decade.  In 2009, the 10 states where per capita spending was highest ranged from 13 to 36 percent higher than the national average, and the 10 states where per capita spending was lowest ranged from 8 to 26 percent below the national average.

The sixth-annual Tennessee Pork Report is chock-full yet again, of waste, fraud, abuse, and mismanagement of taxpayer money by state and local government officials. Despite a changing political landscape in Tennessee, wasteful government spending has not disappeared.

This study examines the potential increase in Medicaid costs from ObamaCare for the State of Texas-one of several states that have challenged the validity of the individual health insurance mandate in court. This study constructs Texas' Medicaid spending projections under ObamaCare to reveal the implied increase in that state's Medicaid spending commitments from the new health care law.

The biggest problem with the Medicaid expansion in the Senate health bill is not the "Cornhusker Kickback," but that it leverages an already flawed formula to determine federal payments to state Medicaid programs

This report outlines Medicaid's current problems, explains how Medicaid is financed, describes and quantifies
the impact of the Patient Protection and Affordable Care Act (PPACA) on state programs, and then offers
policy options for moving forward.

Three Things to Fix Health Care Now:

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

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.

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.

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.

Replacing MinnesotaCare with a state subsidy for individually owned private health plans is one of the key parts of the effort to redesign how the state provides health care to the poor. This can save $100 million on childless adults and up to $600 million if everyone is included.

In light of Oregon facing a budget crisis, the Taxpayer Foundation has issued a master list of budget balancing ideas that do not require raising taxes. These ideas have been collected from Oregon lawmakers, think tank groups, taxpayer organizations, unions, policy analysts, Democrats, Republicans and even ideas utilized in states across the nation.

despite constraints that are both political and self-imposed, we believe that it is quite possible to reduce unnecessary and wasteful spending throughout the New Mexico budget. In order to provide a guide for policymakers, the Rio Grande Foundation has compiled a list of specific budget reduction ideas.

Establish limited priorities for Oklahoma’s state government. Once limited priorities are set, everything else should be considered according to these priorities. The state currently has hundreds of agencies, boards, and commissions; it’s no wonder there is chronic overspending and regular “revenue shortfalls.”

Replacing the current federal financing structure of Medicaid with fixed allotments to the states would help save both state and federal budgets. Without this policy change, states will dig further budgetary holes and the federal government will face an increased likelihood of a debt crisis.  If states received a non-fungible Medicaid block grant from the federal government rather than fungible matching funds, each state would have the incentive to reign in Medicaid spending.  If states were freed from the myriad federal mandates (such as the “maintenance of effort” clause of the Patient Protection and Affordable Care Act) they would gain the ability to run Medicaid efficiently.