Provides a view on projected trends in health care costs and their effect on the long-term outlook for state and local governments in the context of the current economic environment. It addresses 3 key points: (1) the state and local gov¿t. sector's long-term fiscal challenges; (2) rapidly rising health care costs which drive the sector's long-term fiscal difficulties; and (3) the considerations involved in targeting supplemental funds to states through the Medicaid program during economic downturns. The author also analyzed strategies to help states address increased Medicaid expenditures during economic downturns. The simulation model adjusts the amount of funding states would receive based on changes in unemployment and spending on Medicaid services.
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