Medicaid: “The 800-Pound Gorilla”

Last month, State Legislatures magazine ran the article “The 800-Pound Gorilla”, discussing Medicaid, its growing costs, and what state policymakers nationwide are trying to do to maintain the program. Since this issue is also extremely important to Virginia as well, I thought you may like a summary of the article, informing you about the challenges each state is facing when dealing with Medicaid and federal health care reform.

Medicaid has been around for 46 years and cost state and federal governments nearly $400 billion in 2009. In virginia, Medicaid costs have increased three hundred percent over just ten years due to the rising costs of health care and the growing number of people eligible for the program. This is mathematically unsustainable. With federal health care reform, an additional 16 million are expected to enroll in the next three years, adding to the program’s costs.

Because of the huge dent this program makes in our budgets, states across the county are looking towards reforming the system to create “a less expensive, better, more ‘sustainable’ health care system for the poor and disabled”. However, states need more flexibility from the federal government in order to make these reforms. The article puts forth a few states that have attempted different approaches to the management of their Medicaid programs. All these options will need federal approval, but this can be a lengthy process. However, as federal health reform continues to threaten state budgets, the urgency for change will grow greater.

The rest of the article is worth the read because it contains important information on how Medicaid works and discusses some options on how to keep Medicaid costs down. To read the article in full, visit



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