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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: Minnesota

      The very serious reasons for replacing MinnesotaCare with subsidies for private health insurance

      Center of the American Experiement | by Peter J. Nelson | November 29, 2011

      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.

    • SOLUTIONS: Oregon

      Budget solution report offers 100 ideas

      The Taxpayer Foundation of Oregon | November 3, 2011

      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.

    • SOLUTIONS: New Mexico

      Resolving New Mexicoís $450 million Deficit (without raising taxes or cutting K-12 education and Medicaid)

      The Rio Grande Foundation | by Paul J. Gessing and Kevin Rollins | October 31, 2011

      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.

    • SOLUTIONS: Oklahoma, Indiana

      Ten Budget Reforms for 2012

      Oklahoma Council of Public Affairs | by Jonathan Small | August 4, 2011

      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.”

    • SOLUTIONS: Nebraska

      Medicaid The Need for Medicaid Reform Grows Larger After Obamacare

      The Platte Institute | by Brian Blasé and C.L. Gray, M.D. | August 1, 2011

      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.

    • SOLUTIONS: Texas

      Medicaid Reform

      Texas Public Policy Foundation | by Arlene Wohlgemuth, Brittani Miller, and Spencer Harris | February 28, 2011

      Incremental policy changes are not sufficient to address the projected doubling of costs every decade. Texas now has the opportunity to reform the state's Medicaid program for the better. Reform must be carefully designed to ensure against recreating the same problems that have plagued Medicaid since its inception: rising caseloads and mandated benefits.

    • SOLUTIONS: Pennsylvania

      Medicaid Reform

      Commonwealth Foundation | by Michael Bond | February 28, 2011

      Medicaid, the joint federal/state program that was created to provide health care for the poor, celebrated its 40th birthday in 2006. There was no party for the program, however. In Pennsylvania and around the nation, Medicaid is growing at an unsustainable rate and threatens both state and federal budgets.

    • SOLUTIONS: Louisiana

      Cajun Care: Medicaid Reform in Louisiana

      The Pacific Research Institute | by Adam Frey | February 28, 2011

      Louisiana governor Bobby Jindal, and Health Secretary Alan Levine, both veterans of Medicaid reform, have developed a plan based on key reforms such as accountability, consumer choice, cost efficiency, marketplace competition, and transparency.

    • SOLUTIONS: New York

      49 Suggestions for Cutting Billions in State's Medicaid Costs

      February 16, 2011

      Personal shopping and cleaning services for the disabled would be eliminated, weak hospitals could be merged and brand-name drugs would be limited under a series of budget-cutting proposals announced by the New York State Health Department.

    • SOLUTIONS: New York

      Blueprint for a Better Budget

      April 9, 2010

      The document explains why and how New York state developed such massive budget deficits and identifies programmatic changes to begin closing the gaps, including privatization and competitive contracting, cost reductions and tax policy goals to promote economic growth.


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