A new survey of state officials shows that increasing budget pressures could lead states to start clicking down their Medicaid programs. Most have resisted cuts thus far, but the odds of that continuing are becoming less and less likely, according to a report by the Kaiser Commission on Medicaid and the Uninsured.

The report, “Headed for a Crunch: An Update on Medicaid Spending, Coverage and Policy Heading into an Economic Downturn” noted that 2008 was actually a good year for Medicaid program expansion and funding. But quicker rises in beneficiary enrollment and resulting spending could produce a turnabout.

The Kaiser survey also showed that most states are increasing their involvement with home- and community-based alternatives for long-term care. Thirty-eight states are progressing with Long-Term Care Partnership programs, while nine states that expanded their long-term care offerings have pursued the Deficit Reduction Act’s “cash and counseling” option.

For more on the survey, visit www.kff.org/medicaid/7815.cfm.