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The Nelson A. Rockefeller Institute of Government

State and Local Finance: Health Care Finance

Health Care Finance

Kaiser Family Foundation/Rockefeller Institute Report Highlights Trends in Medicaid Expansion

In a just released report, the Kaiser Family Foundation and the Rockefeller Institute of Government of SUNY compared the demographic, fiscal, and economic characteristics of states that have expanded Medicaid and those that have not. To date, 30 states and the District of Columbia have adopted the Medicaid expansion, while the remaining 20 states have rejected expansion or are still debating the issue.
Laura Snyder, Robin Rudowitz, Lucy Dadayan and Don Boyd, September 2, 2015

Medicaid and State Budgets: Clearing Storm, Foggy Forecast

Health care is one of the most talked-about issues in the 2008 presidential campaign. And for all the differences among the leading candidates, there are also important similarities. Among these, one stands out: the central role the 50 states will play in health care reform, regardless of who wins the White House.
Courtney Burke, August 2007

The Medicaid Spending Slowdown: Is it Unusual? Will it Continue?

Medicaid per capita spending (adjusted for inflation) was lower in Fiscal Year 2006 than in the previous year, only the second drop in the program's history. The only other time Medicaid per capita spending fell was between 1995 and 1996. But the decline between 2005 and 2006 was more substantial than the decrease between 1995 and 1996. The fall in Medicaid spending in 2006 represents a significant reversal from recent trends, when growth rates were in the double digits only three years ago. At that time (2001-2003), states were in the midst of a fiscal crisis marked by declining revenues and large increases in Medicaid costs. Prior to 2001, the last time Medicaid grew at a high rate was from 1990-1992.
Courtney Burke, April 2007

Health Spending and State Budgets, FY 2003

This presentation sketches recent state budget problems, examines state budget balancing actions in 2003, and assesses state budget outlook and prospects for health spending for FY 2004.
James W. Fossett, presentation at National Academy for State Health Policy, August 2002

Medicaid and State Budgets in FY 2004: Why Medicaid Is So Hard To Cut

This report assesses how Medicaid was treated in fiscal year 2004 in the budgets of ten states. Drawing on detailed analyses of state budgets, it examines state budget-balancing strategies, with particular attention to changes in Medicaid spending and eligibility compared to other government functions.
James W. Fossett and Courtney E. Burke, July 2004

A Divided Community: The Effects of State Fiscal Crises on Nonprofits Providing Health and Social Assistance

This paper examines the current state revenue crisis, demand for social services, the distribution of social assistance nonprofits, and both long-run and short-run changes in state expenditures to estimate the effects of state fiscal crises on the nonprofit sector associated with human service programs. This study finds divisions among nonprofits that affect the severity of these effects. These divisions are both functional and geographic.
Thomas Gais, Courtney Burke, and Rebecca Corso, The Aspen Institute, November 2003

State Expansion of Medicaid Managed Care Slows

In the nineties, states expanded the use of managed care in Medicaid. Now, as Medicaid costs soar, the benefits of this shift are fading.
Nicholas W. Jenny and Haidy Brown, February 2003.

The Bursting State Fiscal Bubble and State Medicaid Budgets

This paper examines states' policy choices about Medicaid eligibility, benefits, and reimbursement rates in the context of the larger state fiscal environment.
Donald J. Boyd, Health Affairs, Volume 22, Number 1, January/February 2003

Is Medicaid Retrenching?

This presentation looks at whether or not Medicaid is retrenching in various states and how Medicaid affects state budgets.
Courtney Burke and James Fossett, December 3, 2002