One big question for the year ahead is how state Medicaid plans will be affected by state budget problems. The changes in the last Congressional budget bill affect the financial tools that state governments have to fund Medicaid—particularly the prohibition of states from continuing with provider taxes to fund Medicaid and new limitations on state-directed payments to provider organizations (see Federal Budget Bill Brings Major Administrative & Financing Changes To Medicaid, ACA Marketplace & Medicare).

There will also likely be more uninsured people to serve out of state coffers—an additional 10 to 16 million more (see Rewriting The County Playbook). In addition, states will have to pick up more the costs of SNAP benefits and for meeting the health-related social needs of the…