A Mid-Year State Medicaid Budget Update for FY 2012 & A Look Forward to FY 2013: “This report, based on structured discussions with leading Medicaid directors in November 2011 and survey questions emailed to all 50 states and DC in December 2011 and January 2012, builds on findings from Kaiser’s most recent comprehensive 50-state Medicaid budget survey. The report finds that most states are on track with their Medicaid budget and enrollment trends for fiscal year 2012 and do not anticipate the need for significant mid-year cuts. Even so, the report finds that 10 states — California, Colorado, Louisiana, Maine, Maryland, North Carolina, Pennsylvania, Tennessee, Washington and West Virginia — are trying to close 2012 budget gaps by making mid-year revisions, including restricting additional benefits and provider payment rates. In Maine and Washington, the proposed mid-year cuts include broader measures. Looking ahead to fiscal year 2013, many states are planning to take advantage of new opportunities available under the Affordable Care Act (ACA) to integrate care for those who qualify for both Medicare and Medicaid (“dual eligibles”) with the goal of providing better care and reducing costs, according to the report. Many states are also preparing to implement the ACA Medicaid coverage expansion in 2014, and a number of states are moving forward with creating insurance exchanges. States will continue to face the dual challenges of implementing health reform and coping with another year of budget shortfalls heading into fiscal year 2013.”