In this paper, Wakely Consulting Group and Health Management Associates analyze the following: 1) How much strain will state Medicaid budgets be under over the next few years and 2) What types of state characteristics and what types of policy options will allow states the ability address budgetary challenges. We find that state budgets could continue to deteriorate in 2021, states have limited ability to reduce budgetary shortfalls, Federal decisions are important, and long-term Federal help is likely needed to address budget shortfalls. Read our analysis to learn more. 

States, Medicaid, and Economic Hard Times