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Reforming Medicaid Waivers: The Governors’ Council Perspective on Federalism Today

With the federal government entering a period of unprecedented fiscal pressure, we see an opportunity to begin a fundamental realignment of the state-federal relationship.

One area of particular opportunity and concern – for states and the federal government – is Medicaid. This is because Medicaid, which provided $401.4 billion in combined federal and state resources to finance health care for nearly 60 million people in 2010 alone, is by far the largest state-federal program in existence today.

By developing specific recommendations for improving the Medicaid waiver program, we hope to generate insights and provide a model for improving the state-federal relationship in ways that may be applicable to other areas of significant public policy importance as well.

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