The issues of the future of Medicaid and the role of the federal government are extremely salient in the current political and policy environment.  President Bush has proposed fundamental changes in the way the federal government interacts with and provides financial support for the states in their Medicaid programs.  Initially at least, the Governors argued that their current budget crises would be made more severe by the Administration's proposal and lobbied the Congress for significant changes to the federal budget for Medicaid (Pear, New York Times, 2/26/2003).  While the NGA and many Republican Governors appear more willing to consider the Administration's plan, many of the Democratic Governors and members of the Congress in both parties, however, have expressed concern about the ultimate impact of the continued pressure on Medicaid and how accompanying changes will impact the elderly. 

This project seeks to identify proposed changes in Medicaid for 2003, analyze their potential effects on the rural elderly and disabled, in particular, and produce a policy paper to inform both state and federal policymakers on the likely effects on the elderly and disabled.