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At a meeting of the nation’s governors on Saturday, state leaders predicted that the worst economic times still lie ahead—at least at the state level.

Vermont Gov. Jim Douglas (R), Chairman of the National Governors Association, pointed out that many states’ revenues continue to deteriorate, and that previous financial forecasts are constantly being revised downward, reports the New York Times. One big concern is healthcare reform legislation that would dramatically increase the number of people on state-funded Medicaid programs, the governors said.

A number of governors, including Douglas and West Virginia Gov. Joe Manchin III (D), suggested states should take action on their own, crafting reform legislation at the state level that would be more tailored to their own residents. Washington Gov. Christine Gregoire (D), a proponent of national healthcare reform, suggested Congress should consider delaying a Medicaid expansion if states are still struggling financially in a few years’ time, the Times reports.

Although a report issued at the end of the NGA meeting concludes that the coming fiscal year will be “the most difficult to date,” many governors acknowledged that the situation could be worse. Without the $787 billion stimulus package passed last year, the recession could have been both longer and deeper, Douglas said.