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Medicaid: Focusing on State Innovation

As the availability and affordability of private health insurance coverage have decreased in recent years, states have sought to expand their Medicaid programs to provide for those who lose coverage from private sources and to improve coverage for vulnerable low-income populations. These efforts, however, have led to some further declines in private insurance, the magnitude of which is controvertible. In recent years, Medicaid enrollment has increased, after declining between 1995 and 1998.5With the downturn in the economy and rising health care costs, many states now face record deficits and shortfalls in their Medicaid budgets. The ability of states to continue to expand their Medicaid programs, or simply to maintain existing eligibility and benefits levels, is questionable.

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Medicaid: Focusing on State Innovation, Juliette Cubanski and Janet Kline, The Commonwealth Fund, April 2003