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Governors' Proposed Budgets for FY 2018: Focus on Medicaid and Other Health Priorities

Executive Summary
  1. States that do not operate on the July 1 through June 30 budget cycle include Alabama, DC, and Michigan (October 1 – September 30), New York (April 1 – March 31), and Texas (September 1 – August 31).

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  2. National Conference of State Legislatures, 2017 State & Legislative Partisan Composition, (National Conference of State Legislatures, March 2017), http://www.ncsl.org/portals/1/documents/elections/Legis_Control_2017_March_27_11am.pdf

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  3. Of the 18 states with divided control, three have split legislatures. Nebraska’s legislature is unicameral and nonpartisan.

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Issue Brief
  1. Centers Medicare and Medicaid Services. National Health Expenditure Projections 2016 – 2025 (Washington, DC: Centers for Medicare and Medicaid Services, February 15, 2017). https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsProjected.html.

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  2. Lucy Dadayan and Donald J. Boyd, Widespread Declines in State Tax Revenues in the Second Quarter of 2016 (New York, NY: The Nelson A. Rockefeller Institute of Government, November 2016), http://www.rockinst.org/pdf/government_finance/state_revenue_report/2016-11-30-srr_105.pdf.

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  3. Lucy Dadayan and Donald J. Boyd, Weak Tax Revenue Growth in the Third and Fourth Quarters of 2016 Amid Uncertainty About Federal Tax Changes (New York, NY: The Nelson A. Rockefeller Institute of Government, March 2017), http://www.rockinst.org/pdf/government_finance/state_revenue_report/2017-03-09-srr_106.pdf.

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  4. Robin Rudowitz and Allison Valentine, and Vernon Smith, Medicaid Enrollment and Spending Growth: FY 2016 & 2017 (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, October 2016), https://www.kff.org/medicaid/issue-brief/medicaid-enrollment-spending-growth-fy-2016-2017/.

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  5. States that do not operate on the July 1 through June 30 budget cycle include Alabama, DC, and Michigan (October 1 – September 30), New York (April 1 – March 31), and Texas (September 1 – August 31).

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  6. National Association of State Budget Officers, Fall 2016 Fiscal Survey of the States (Washington, DC: National Association of State Budget Officers, December 2016). https://higherlogicdownload.s3.amazonaws.com/NASBO/9d2d2db1-c943-4f1b-b750-0fca152d64c2/UploadedImages/Fiscal%20Survey/Summary%20of%20Fall%202016%20Fiscal%20Survey.pdf.

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  7. Lucy Dadayan and Donald J. Boyd, Double, Double, Oil and Trouble (New York, NY: The Nelson A. Rockefeller Institute of Government, February 2016), http://www.rockinst.org/pdf/government_finance/2016-02-By_Numbers_Brief_No5.pdf.

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  8. Lucy Dadayan and Donald J. Boyd, Weak Tax Revenue Growth in the Third and Fourth Quarters of 2016 Amid Uncertainty About Federal Tax Changes (New York, NY: The Nelson A. Rockefeller Institute of Government, March 2017), http://www.rockinst.org/pdf/government_finance/state_revenue_report/2017-03-09-srr_106.pdf.

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  9. While Kentucky had not released a supplemental budget for FY 2018 at the time this report was prepared, the proposed requirement regarding community engagement and employment activities is included in the proposed “Kentucky Health” Section 1115 Medicaid Demonstration waiver request submitted to CMS on August 24, 2016 which was still pending at the time of this report; accessed at https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ky/ky-health-pa.pdf.

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  10. Six states (Arizona, Arkansas, Indiana, Iowa, Michigan, and Montana) have received Section 1115 waiver approval to charge premiums or monthly contributions that are not otherwise allowed for their Medicaid expansion adults; these amounts are generally 2% of income, equivalent to what beneficiaries from 100-138% FPL would incur if they enrolled in Marketplace coverage.

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  11. Some groups and services are exempt from cost sharing, including children enrolled through mandatory eligibility pathways, emergency services, family planning services, pregnancy-related services, and preventive services for children.

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  12. MinnesotaCare is now the state’s Basic Health Plan under the ACA. MNsure is the state’s Marketplace.

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  13. Samantha Artiga, Jennifer Tolbert, Petry Ubri, and Robin Rudowitz, Views of Governors and Insurance Commissioners on ACA Repeal and Changes to Medicaid: Responses to a Congressional Request for State Input on Health Reform (Washington, DC: Kaiser Program on Medicaid and the Uninsured, March 2017), https://www.kff.org/medicaid/issue-brief/views-of-governors-and-insurance-commissioners-on-aca-repeal-and-changes-to-medicaid-responses-to-a-congressional-request-for-state-input-on-health-reform/.

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