The Medicaid hand-off: who will end up running the program?

The Medicaid program may get an overhaul this year, as Congress pursues the deep spending cuts needed to balance the budget, and governors seek greater control of the program. Supporters of dramatic Medicaid reform say it is essential to curbing runaway entitlement growth, and giving states the flexibility they need to achieve greater efficiencies in the delivery and financing of care. Skeptics contend that deep cuts will jeopardize health care coverage for millions of poor children and families, and slash already parsimonious payments to providers.