After making steep cuts during their 2009 through 2011 budget cycles, states continue to experience budget problems. Recent projections indicate that 44 states and the District of Columbia will see budget shortfalls during fiscal year (FY) 2012, which begins July 1, 2011, in most states. In many states, increased Medicaid enrollment caused by the recession is a significant contributor to these deficits. The new health reform law--the Patient Protection and Affordable Care Act (ACA)--provides opportunities for cash-strapped states to find savings in the Medicaid program and to take advantage of grant and demonstration opportunities that enable them to receive additional federal dollars. One of the opportunities will not be available until 2014, when the new law takes effect. The remaining opportunities are available for states to consider immediately. This Insight on the Issues explores some of these opportunities and is intended to serve as a tool for state health policymakers as they consider what the new law has to offer.
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