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All but three states are experiencing bursts of revenue on target or above projections, according to the findings of a new survey. Medicaid, the country’s biggest payer of long-term care, receives much of its funding from state budgets.

More than half the states have revised their estimates upward less than half way into the fiscal year, according to the 50-state survey conducted by the National Conference of State Legislatures. The fiscal calendar begins in July for most states.

However, state budget leaders worry that the cuts, borrowing and decreased spending during the last few years have left most states in worse financial shape than when the economy started declining three years ago.

“Revenue improvement is extremely welcome news,” said John Hurson, the president of NCSL and a Maryland state delegate. “However, higher Medicaid costs and concerns for programs that have been cut or under-funded in the last few years will put tremendous pressure on state budgets.”