Both newly elected and re-elected governors have made the choice to be brutally honest with constituents by outlining the dire straits of their respective state budgets in inaugural remarks. Medicaid and other healthcare funding sources are at risk in many areas.

For some states, balancing the budget will include cuts to programs for seniors. California Gov. Jerry Brown (D) says he will increase taxes only if state residents want them. Brown’s state budget proposal, issued Jan. 10, eliminates funding for adult daycare services, according to local news reports. Cutting the program, which includes physical therapy, preventive medical care and other services, could force more seniors into nursing homes, opponents argue.

Other states, including Illinois, are bracing for cuts to social programs such as Medicaid. Gov. Patrick Quinn (D) is facing $8 billion in unpaid bills to social services agencies and an underfinanced pension system, The New York Times reported. Quinn also has signed a whopping 66% increase to the state’s income tax rate.