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State Health Reform in the Midst of Fiscal Crises

Despite budget crises and other economic challenges facing states, some are expanding eligibility and implementing strategies to increase enrollment of adults and children in public programs. Launching and financing these efforts under current conditions is requiring even more creativity, political commitment, and cooperation among state agencies than usual. The availability of stimulus funding and the possibility of federal health reform are also influencing how states pursue their policy goals.

For example, Wisconsin and Maryland are moving ahead with health reforms aimed at increasing insurance coverage for children and adults. Wisconsin is expanding eligibility and enrollment as part of an effort to cover 98 percent of its population, while Maryland is working to expand its coverage of low-income adults. Maryland is also implementing a new strategy using income tax forms to identify children who are potentially eligible for its Medicaid and CHIP programs.

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