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Medicaid Expenditures and State Budgets: Past, Present, and Future

Author

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  • David Wildasin

    (Martin School of Public Policy and Administration and Department of Economics, University of Kentucky)

  • James Marton

    (Martin School of Public Policy and Administration and Department of Economics, University of Kentucky)

Abstract

Rapid spending growth has made Medicaid a major element in state budgets; financial support from Federal matching grants is now a main component of state government revenues and of intergovernmental fiscal relations. We discuss recent, ongoing, and prospective reforms of intergovernmental finances and regulations, including the 1996 welfare reform, the introduction of Medicare Part D, Section 1115 waivers, SCHIP reauthorization, and a shift to block grants. Each would affect the assignment of responsibilities between the state and Federal governments, the viability of which is questionable due to current and future interstate demographic and policy variation, population aging, and Federal fiscal imbalances.

Suggested Citation

  • David Wildasin & James Marton, 2007. "Medicaid Expenditures and State Budgets: Past, Present, and Future," Working Papers 2007-04, University of Kentucky, Institute for Federalism and Intergovernmental Relations.
    • Handle: RePEc:ifr:wpaper:2007-04
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    Cited by:

    1. Wildasin, David E., 2007. "Pre–Emption: Federal Statutory Intervention in State Taxation," National Tax Journal, National Tax Association;National Tax Journal, vol. 60(3), pages 649-662, September.
    2. David E. Wildasin, 2021. "Open-Economy Public Finance," National Tax Journal, University of Chicago Press, vol. 74(2), pages 467-490.
    3. Hikaru Ogawa & David E. Wildasin, 2009. "Think Locally, Act Locally: Spillovers, Spillbacks, and Efficient Decentralized Policymaking," American Economic Review, American Economic Association, vol. 99(4), pages 1206-1217, September.
    4. Rosella Levaggi, 2008. "Decentralisation vs fiscal federalism in the presence of impure public goods," Working Papers 0812, University of Brescia, Department of Economics.
    5. Rosella Levaggi & Francesco Menoncin, 2013. "Soft budget constraints in health care: evidence from Italy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(5), pages 725-737, October.
    6. Marie Courtemanche & Joanne Connor Green, 2017. "The Influence of Women Legislators on State Health Care Spending for the Poor," Social Sciences, MDPI, vol. 6(2), pages 1-24, April.
    7. Richard F. Dye, 2008. "The dynamic between municipal revenue sources and the state-local relationship in New England," New England Public Policy Center Working Paper 08-1, Federal Reserve Bank of Boston.
    8. Datta, Anusua & Vandegrift, Donald, 2011. "Effects of welfare reform and the state children’s health insurance program on medicaid and total health expenditures," MPRA Paper 36486, University Library of Munich, Germany.

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