The authors examine changes to state Medicaid programs as a result of Medicaid rule changes and the Deficit Reduction Act of 2005.  They find that most states have altered their Medicaid programs but have not fully utilized the new flexibility granted to them by the federal government.  The authors further suggest that in an economic downturn states may easily and profoundly alter their Medicaid programs under the Bush administrations policies.   

Coughlin, T. A., & Zuckerman, S. (2008). State responses to new flexibility in Medicaid. Milbank Quarterly, 86(2), 209-40. http://www.milbank.org/860202.html

Authors: Teresa A. Coughlin, Stephen Zukerman