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

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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.

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File URL: http://www.ifigr.org/publication/ifir_working_papers/IFIR-WP-2007-04.pdf
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Bibliographic Info

Paper provided by University of Kentucky, Institute for Federalism and Intergovernmental Relations in its series Working Papers with number 2007-04.

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Length: 43 pages
Date of creation: Apr 2007
Date of revision:
Handle: RePEc:ifr:wpaper:2007-04

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Cited by:
  1. 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.
  2. Wildasin, David E., 2007. "Pre–Emption: Federal Statutory Intervention in State Taxation," National Tax Journal, National Tax Association, vol. 60(3), pages 649-62, September.
  3. Rosella Levaggi, 2008. "Decentralisation vs fiscal federalism in the presence of impure public goods," Working Papers 0812, University of Brescia, Department of Economics.
  4. Hikaru Ogawa & David Wildasin, 2007. "Think Locally, Act Locally: Spillovers, Spillbacks, and Efficient Decentralized Policymaking," Working Papers 2007-06, University of Kentucky, Institute for Federalism and Intergovernmental Relations.
  5. 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.

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