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September 2003
 States Respond to
Fiscal Pressure: State
Medicaid Spending Growth and Cost Containment
in Fiscal Years 2003 and 2004 States are
beginning what is for some the fourth consecutive year of fiscal
stress. State tax revenues declined significantly in 2002 and
remained at that low level throughout 2003. As they completed
their 2003 fiscal year and developed budgets for fiscal year 2004,
states faced total budget shortfalls of at least $70 billion. To
close these large budget gaps, states reduced planned spending and
some began to raise taxes and fees. After the beginning of fiscal
year 2003, states reduced budgeted spending levels for the year,
and many states proposed to reduce fiscal 2004 spending.
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