Most states’ new fiscal years started Thursday. It promises to be another brutal year as states continue to battle budget shortfalls. Government programs such as Medicaid again could face the chopping block.

States face a combined deficit of $89 billion in the new 2011 fiscal year, according to the National Conference of State Legislatures. Eleven states are projecting major budget gaps into 2013. Meanwhile, Medicaid rolls are expected to swell.

President Obama recently asked Congress for $50 billion in emergency aid to states, but concerns about the mounting deficit have made lawmakers skittish such a commitment. Meanwhile, Congress has been unable to pass a six-month extension of the increase in the federal medical assistance percentage (FMAP), which expires at the end of December. Nursing home providers continue to urge their lawmakers to pass such a bill, which would provide more federal Medicaid dollars to states.