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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.

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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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