This report relays the perspective of leading state Medicaid directors to describe the fiscal strain on Medicaid and other safety-net programs as enrollment swells and state tax revenues shrink, raising the prospect of program cutbacks. It draws on focused interviews with leading Medicaid directors in November 2008. It augments the most recent Medicaid budget survey report that was based on a survey and interviews with all state Medicaid directors in July and August 2008, at the beginning of state fiscal year 2009.

 Report (.pdf)