terrible fiscal situation next year. Economic growth has not risen sharply enough to offset the loss of federal stimulus dollars and greater citizen demand for services, especially healthcare.One of the biggest problems is that "spending on Medicaid is expected to consume an increasing share of state budgets and grow much more rapidly than state revenue growth, resulting in slow or no growth in education, transportation or public safety." After federal stimulus wore off, the states increased their Medicaid spending by an average of 29 percent this year, according to the Kaiser Family Foundation. Even though about half the states have taken steps to control Medicaid costs, many budget officials believe they haven't gone far enough.

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