IDEAS home Printed from
   My bibliography  Save this paper

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


  • 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)


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

    Download full text from publisher

    File URL:
    Download Restriction: no

    Other versions of this item:

    References listed on IDEAS

    1. David E. Wildasin, 2006. "Disasters: Issues for State and Federal Government Finances," Working Papers 2006-07, University of Kentucky, Institute for Federalism and Intergovernmental Relations.
    2. Wildasin, David E., 1997. "Externalities and bailouts : hard and soft budget constraints in intergovernmental fiscal relations," Policy Research Working Paper Series 1843, The World Bank.
    3. Caplan, Arthur J. & Cornes, Richard C. & Silva, Emilson C. D., 2000. "Pure public goods and income redistribution in a federation with decentralized leadership and imperfect labor mobility," Journal of Public Economics, Elsevier, vol. 77(2), pages 265-284, August.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Wildasin, David E., 2007. "Pre–Emption: Federal Statutory Intervention in State Taxation," National Tax Journal, National Tax Association, vol. 60(3), pages 649-662, September.
    2. 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.
    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. 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.
    5. repec:gam:jscscx:v:6:y:2017:i:2:p:40-:d:95937 is not listed on IDEAS
    6. 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.
    7. 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.

    More about this item

    NEP fields

    This paper has been announced in the following NEP Reports:


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ifr:wpaper:2007-04. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (David E. Wildasin). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.