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There are about 181,000 homeless in California one third of the total in the US. This $6.4 billion bond issuance for borrowing funds was approved by just over 50% of the vote. It will go to create more affordable housing so badly needed in California's out of control housing prices. People tended to think nothing works and out of apathy did not vote. But the scale of the problem required effort at the state level or federal level with funding in the tens of billions of dollars for affordable housing. This is the first time that this has happened even though Silicon Valley and capital markets have wasted hundreds of billions of dollars in dubious companies and projects that have contributed little to the standard of living and ease of living of the American people, including essential infrastructure and health, education services. The dilapidated and crumbling infrastructure, of subways, streets and bridges in New York City is another aspect of the same problem of serious, serious lack of affordable housing in California. It also creates the kind of class divisions in society that FDR-Truman-Kennedy sought to remove since the 1930's. ...

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The doubts among the unvaccinated and America's pandemic of the unvaccinated in the south and west of the country, difficulty reaching a consensus on things as basic as spending $45 billion or 2% of the $2 trillion Biden plan for workers and families on 2 years of community college, or finding a way to stem what is an alarming decline in enrollment in college of young men in America, all go back to a standoff between Republicans and Democrats. Tennessee in the South is Republican yet passed a bill supporting state paid community college with a supermajority, yet at the national level it is lacks support of Republicans and centrist Democrats. To see how this happens this NYT report presents the picture from the Democrats side of how Montana residents blocked a National Heritage area in the state. Other stories relate to distortions from the other side from the Republican point of view. One man, one vote is not entirely the way Democracy was designed by Jefferson, Madison and other founders. The Senate of the US is based on one state one vote, giving Montana an equal vote as California or New York. At one time Mike Mansfield, Democrat of Montana was the Senate majority leader. The intent was to design a system that looks not just for democracy but checks on majorities of the moment.  This means unity is the way to renewal of America, for building its infrastructure, education and health care. If Tennessee feels that way about community college it should express it, so should other states in supporting president Biden's plan to Build Back Better. ...

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About 14 million people are in poverty or slipping below the poverty line according to Paritatische Wohlfahrtsverband, umbrella organization for welfare organizations. German per capita wealth is about 52,000 euros but there is growing inequality in wealth and incomes.  A household with 2 parents and 2 children is at the poverty line at 2410 euros a month or about 29000 euros a year. Social safety net under Hartz IV does little to help because it is set at 449 euros a month with 285 to 376 euros for each child. This is expected to go up to 503 euros a month per person in 2023. Even though experts say at least 650 euros are needed per month to live  with dignity. Under this system only 5 euros per day is set by Hartz IV for food, says DW.com, which is shocking. It means food of lesser quality or less food goes to the less well off. About 2 million people use food banks. Prices are up 12% in 2022 for basics such as bread, vegetables, milk and cheese. One study shows old age poverty is likely to affect 20% of Germans by 2036. The situation is bad for elderly, students and women. Women have worked part time reducing their income.  A student with federal funding gets 934 euros a month which is well below the poverty line. A new program for 200 billion euros is planned by German government to protect against inflation for households. Minimum wage is 12 euros per hour so that someone who works 40 hours a week makes 1480 per month in net income. After inflation this is close to the poverty line. Such is the situation for Germans today even after decades of growth and being seen as an export powerhouse. Compare this to the situation in India where the food program of the Modi administration continues to support food supplies that are adequate for feeding a family right through the pandemic for 800 million people and one sees that the idea of what is a rich or poor country is turned on its head. It is simply the will of the culture of a people and a country and its leadership that makes its limited or larger national wealth available to all its citizens, for the basics to fulfill the idea that "all men are created equal and they are endowed by their Creator with some inalienable rights to life, liberty and the pursuit of happiness," enshrined in the minds of Asia borrowed from America. ...

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The American Medical Association came out against the public option in President Obama's health care reform plan. The outpouring of comments on this article show that public opinion today seriously questions the actions of the AMA, and think that this is not in the best interests of the nation. Its the kind of outpouring of criticism that GM's old management received from readers fed up with the management of the Detroit automakers, before the GM bankruptcy. Out of the 26 most read or recommended comments on this article shown on the link to the article in the NYT, 25 were strongly critical of the AMA's position on health care, none were in favor, and one was critical of the insurance companies. The 25 that were strongly critical had a total of reader recommends of 6539 readers when they were totalled up for all 25 comments. Some of these comments were strongly critical and explained at length why. Some were from doctors who disassociated themselves from the AMA. One suggested that the American College of Physicians also represented doctors, and the AMA represented only one group of mostly older doctors who are against any change. The financial crisis and the election of a new President, the changes in the country since the last failed reform effort in 1993, the new mood of the country as it changes to its more frugal past, a new generation of doctors and a new generation of young people coming to the fore, all may mean that things are no longer the same, and actually very different. Are the people running the AMA, like the people who were running GM a short time ago, not able to see how they are perceived by the public? ...

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Senators Mike Lee of Utah and Jerry Moran of Kansas declare their opposition to the Republican Health Care bill proposed by Senator McConnell. This decision by the two senators makes it impossible to begin debate on the bill. Earlier two other senators, Susan Collins of Maine and Rand Paul of Kentucky announced their opposition. This means the Republican health care bill has no chance in the Senate even after changes to the bill passed by the House of Representatives. Republicans have a thin majority in the Senate make it difficult to pass legislation. Collins met with residents in Maine and Moran with people in his home state of Kansas, and both senators heard a lot about the negative effects of the Republican bill on people in their state. The bill is seen as hurting people in rural areas, elderly, and not likely to do enough to bring down premiums. Its plan to slash Medicaid spending has drawn strong opposition from all Democrats.

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U.S. added 245,000 jobs in November. Unemployment rate drops from 6.9% to 6.7% as some Americans give up looking for work. The concern now is not the rate of job creation which is healthy but the drop outs from the workforce.  Concern arises from the long drawn out effects of the 2009 financial crisis and its effects which were seen over a decade. This report in NYT says the share of prime age Americans who were employed returned to the January 2008 level in 2019. And then the pandemic hits putting everything back again. This time if the lesson is learned about the long term damage to working families it is that this be tackled as a priority for the central bank, the U.S. Federal Reserve, an the Treasury, and Council of Economic Advisors, under the leadership of president Biden. Fortunately both Yellen and the new proposed head of the Council are students of labor markets and have stated this is one of the lessons they have learned and will act on. As this report says the opiate crisis, the risks of addiction increased, and there were links to the long period people were without jobs. The longer a person is without a job the more likely he will become permanently unemployed. The hope now is that the vaccination effort could bring people back to work quickly as business and life resumes in 2021, with workers being hired back. The share of prime age Americans working in November is 76.5% compared to 80.5% in February, which means this has to go up by about 4 percentage points. The people who are not in the labor force today but still want a job are 2.2 million. It is this that needs to be the focus of the new administration, central bank, and Congress. ...

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Adirondack National Park with its 2 million acres of wilderness has St Regis Canoe Area, a canoeing part of the wilderness. Here The Guardian shows Megan Bergman taking up the challenge of going up the Seven Carries route in this wilderness finding peace and mental health in the waters  with her backpack in the canoe. Take this trip up the rivers and ponds in the area and through portages which are carrying of the 15 pound light Kevlar canoes on one's shoulders or arms for the sections of land that connect the ponds and rivers. The American Indian and the early French and British explorers made their way through upstate New York and around the Great lakes in Michigan in this way.  Megan says she wanted that sense of calm, of transcendence, and the fierce delight of putting her backpack into the canoe after the portage. She says she felt content out on the water in the wilderness with a friend. I wanted to feel reverent and at peace with this wilderness which felt safe, she says. ...

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Biden's very conservative choices for his cabinet which one British reader of The Times calls UK One Nation type choices. Many of the cabinet members could easily have served under a Republican administration before Trump or a Democratic administration in the tradition of Harry Truman in the 1950's. No members of the cabinet belong to the Bernie Sanders wing of the Democratic Party.  A look at the Truman administration after 1950 shows John Wesley Snyder, who headed a bank in St Louis and worked for the Reconstruction Finance Corporation under Franklin Roosevelt performing a key role for integrating 8 million GI soldiers into the economy, and implementing the Marshall Plan. A similar job awaits another banking official Janet Yellen in Biden's cabinet to keep people employed during the pandemic. Xavier Becerra, currently attorney general of California, and formerly Congressman for 24 years, who endorsed "medicare for all" is the new Health Secretary. He grew up in a one room apartment with his Mexican parents. Secretary of State goes to Anthony Blinken, Dean Acheson was in this role under Truman as the Cold War surged with the Berlin crisis and the Iron Curtain in Eastern Europe. Today the challenges from Russia and China are taking the shape of a revival of tensions. George Marshall who led American forces in the war, was secretary of defense. This position is given to a soldier Gen. Lloyd Austin who led forces in the wars in the Middle East. This has the potential to deliver better results after the years when America veered off course under the administrations of Reagan, Clinton, Bush and Obama, following the Truman, Eisenhower administrations that setup the recovery after World War II. Today after the banking crisis of 2009, disastrous healthcare and infrastructure neglect in the U.S., followed by the pandemic, a recovery like the one after World War II is needed.   ...

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The famous Chilean author of books including: A Long Petal of the Sea, talks to the BBC about her life and travels, about her home country Chile. She left Chile in 1975, spent 13 years in Venezuela and three decades in California. Here she talks about Chile as Pablo Neruda describes it as that long petal on the sea, a country with an insular mentality surrounded by high Andes range, Patagonia, and the Atacama desert. She is not entirely critical of Chile's development under the administrations that came after the dictatorship years. Chile has some upward mobility, the economic conditions have improved compared to the rest of Latin America even though a lot remains to be done. The events in Venezuela show the limits of regimes that have attempted change. Even with administrations from both ends of the spectrum Argentina has turned to the IMF in economic crisis the last in 2018. Brazil has seen a commodities boom followed by a severe bust, and the lack of funding for basic services including sanitation and health. This gives a sobering view of the economic situation in Latin America. Allende says Chile has modernized and created prosperity though at some social cost.  Isabel Allende is still nostalgic about her home country and still calls it home as she reaches 75 years, with a world wide audience for her books in 42 languages, 70 million copies sold. ...

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With use of the software technologies and cloud computing Athenahealth hopes to revolutionize the medical records of physician practices. Here Joseph Rago of the WSJ talks to Jonathan Bush, CEO of Athenahealth. Bush says the way things are done now in healthcare there is no choice and choosers, and ther is not thing like a market in health care and people in Washington DC don't understand remotely why a market might be remotely useful. The deep problem in American health care he says is that no one knows the actual value of the services doctors give, not even the doctors, and the complexity of the method of payments keeps everything hidden, as doctor's clerical staff bills your treatment to insurance companies picked by your employer, and pays the doctor through money taken from premiums or foregone wages. Athena designed a program to digitize records and automate billing and is moving into clincal record keeping. It now has 15,000 physicians in 43 states using its program as avirtual office and growth at 30%....

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Bernie Sanders is reelected Senator from Vermont, as one of the oldest and most senior members of the US Congress in history. He will be 89 at the end of his fourth term in the US Senate. At 83 years he is the most resilient and active Senator in the US. Bernie Sanders support was key for president Biden's election in 2020. “It should come as no great surprise that a Democratic party which has abandoned working-class people would find that the working class has abandoned them,” Sanders said. “First, it was the white working class, and now it is Latino and Black workers as well. While the Democratic leadership defends the status quo, the American people are angry and want change. And they’re right. “Today, while the very rich are doing phenomenally well, 60% of Americans live paycheck to paycheck and we have more income and wealth inequality than ever before. Unbelievably, real, inflation-accounted-for weekly wages for the average American worker are actually lower now than they were 50 years ago. “Today, despite an explosion in technology and worker productivity, many young people will have a worse standard of living than their parents. And many of them worry that Artificial Intelligence and robotics will make a bad situation even worse. “Today, despite spending far more per capita than other countries, we remain the only wealthy nation not to guarantee healthcare to all as a human right and we pay, by far, the highest prices in the world for prescription drugs. We, alone among major countries, cannot even guarantee paid family and medical leave.” ...

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Economists at the IMF estimate that the public debt of the leading 10 industrialized countries would reach 114% of GDP by 2014, from 78% today. The governments then owe about $50,000 for each person in the country. Unlike World War II this situation is not temporary, because of the pension and health care costs of a population that is getting older. So what is to be done? Without the stimulus, the deep and prolonged recession would lead to greater damage to the finances of these countries. But continued in this manner the government would crowd out private investment and lead to lower economic growth. In some countries, Greece, Ireland, Italy Portugal and Spain it might lead to default, in other countries the real cost of the debt may be reduced through inflation. In the USA yields on 10 year Treasuries reached about 4% on June 10th, in December it was about 2%, a consequence of the economic recovery. If interest rates are allowed to rise too fast, it might abort the economic recovery. A rise in taxes is also not the answer, because in Europe the taxes are already at 40%, in America they are around 30%. But raising consumption taxes at the time when the economy was fragile, aborted a recovery in Japan during Japan's earlier crisis decade. A caution signal that says fiscal tightening can backfire, especially some years after a banking crisis when things are still in a weak condition. Some steps that can be taken are raising the retirement age, which would cut pension costs as people work longer and would boost tax revenues, and eliminating the tax deduction for home mortgage payments in the US. Its important to build credibility that the government and the legislative bodies are serious about controlling the finances and acting with prudence. In America wasteful health care spending is a priority, as this would reduce the burden on public finances considerably , and should be as much of a priority for the new Obama administration, as providing universal health care. With today's finances its not something that can be put off....

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Department of Education invites controversy because of diversity programs and "transgender" as culture ignoring health risks. Established by president Jimmy Carter in 1979. Education in the US is run at the state level by each American state administration compared to UK where it is done at the national government level. It has one of the smallest budgets of any agency at 4%, Transportation is 1.7%, Agriculture 3.0%. Most of its work is overseeing $120 billion of federal grants and programs for public education through high school. It supports districts with low income students with $18 billion aid. Head Start program supporting 883,000 low income pre school children in 2022 gets federal aid from Department of Health and Human Services. National School Lunch Act of 1946 by Harry Truman is not affected as it is run by states,  federal aid comes from Department of Agriculture to 20+ million children. Republicans oppose spending about $1 billion to support Diversity program DEI initiatives and support for "cirtical race theory." There is opposition to "transgender." Britain's NHS had a commission look into transgender and says it poses health risks to children and young people. It also adds to anxiety of parents. Republicans are 53 -47 in majority in Senate- to scrap the agency Republicans need 60 votes in the Senate. The likely option is that they will pass a bill putting many of the functions in other agencies reducing its impact- between HHS, Treasury and Interior agencies. ...

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Amy Hood growing up in a small town in Kentucky, then a move to Nashvile, Duke and HBS. She joined Microsoft in 2002 on its investor relations team. She moved into management the same time as Nadella who is CEO. Before the pandemic Microsoft's capital expenditures and investments cost about $16 billion. It is now 4 times that at $64 billion. It is Amy Hood's job as Chief Finanacial Officer to see that all that money is well spent for products with demand. AI services bring in about $10 billion annually.  Yet this may just be deflecting by Wall Street of the real question about the funding needs that are being neglected in education, health care and child care, when huge amounts of capital are being diverted by capital markets in ways reminiscent of the warnings of Franklin Roosevelt at the Democratic Convention of 1932. Warnings that the whole capital markets system was not working right, was only defunding the vital needs of the American people. ...

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It took a week longer for each country to impose a lockdown. In China first Wuhan then the whole country went into lockdown and quarantine. The same process is repeated in Europe and in America as authorites see numbers of infections increasing rapidly without strict controls. First the Lombardy region in Italy around Milan, then the provinces in Northern Italy, followed by a complete lockdown in the country on March 10 as infection spread faster without lockdown and enforcement of lockdowns. Germany and Britain follow Spain and Italy on March 20. France followed Spain in the days after Italy's complete lockdown. Macron ordered the lockdown on March 16 with stringent enforcement. Infectious Disease specialists at Imperial College warned of "unintended consequences for the entire nation" if a lockdown of Britain did not take place. The goal is to limit the spread of infections from rapid to slow as public health systems and economic measures are ramped up in preparation for the crisis. Most countries were lacking the preparatory steps having lost time waiting to see what happens next or analyzing data in the vain hope the virus does not spread.  Bad economic results of lockdowns were initially a concern, but this concern became less important as the coronavirus spread rapidly in Europe. Decision makers in Europe decided that not acting forcefully would lead to equally or worse economic outcomes. Public health systems overwhelmed would diminish public confidence rapidly and lead to equally bad or much worse economic outcomes. The European Union executive body has supported state aid, stimulus action and border controls in this crisis. In America and in Europe the hope is that shoring up the safety net with massive aid to businesses and households would buy time to tackle and overcome the coronavirus through a combination of lockdowns, quarantines, contact tracing, large scale testing and medical technology measures. The examples of China, South Korea, Taiwan showed this pathway exists for phased control and reducing fatalities to zero. ...

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This report from Brazil is of major relevance to India in its growth efforts, and for aging societies such as China. In many ways showing the price countries and the people pay when growth is mismanaged. A major crisis is hitting countries such as Brazil as fewer young people and young workers support an aging population of retirees. This is to be seen in the money allocated in Brazil's budget- only 3% goes to infrastructure, 3% to education, health gets 7%, and retirement system takes up as much as 43% of the budget. Increasing retirement obligations are nearly bankrupting the Rio de Janeiro state government.  At the core of this crisis is a steadily aging population that is happening now faster than in the developed world. Also part of this is the fact that fertility rates have dropped rapidly in Brazil, the rest of Latin America, and in China. It took just 27 years in Brazil and 11 years in China for fertility rates to drop from 6 to below 3, creating a situation where there are fewer young people to join the workforce as retirees live longer and the retired population increases. This report shows that it took 82 years for the fertility rates to drop from 6 to 2 in the U.S. so that the U.S. had a longer period in which to build up infrastructure.  Only 50% of Brazil's sewage is treated, and sanitation systems need investment. The average adult has about 8 years of schooling. An unfunded and unfundable social security system means infrastructure, health and public services such as transportation will remain unfunded for years to come. China's policymakers have done far better by building infrastructure rapidly yet face the same squeeze of aging population lower fertility rates as China's modernization continues. India needs to learn from such failures and successes in framing its own policies. Unrealistic giveaways or promises such as Brazil's retirement age of 55 and poor priorities of soccer stadiums in the northeast over sanitation, health, education, have a steep price. Good intentions are not enough as the Workers Party in Brazil granted pensions to farmers and informal workers without generating the sustained growth needed for funding the pension system, with $3 billion paid in and $36 going out for this added benefit.    ...

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President Obama has 63% job approval rating in a New York Times/CBS News poll. His backing is among Democrats and independents alike which is very useful for Obama.But the poll shows more American having faith in the President than in the handling of specific issues. He gets good approval on foreign policy initiatives at 59%, but in the handling of the Auto bankruptcy, or of health care his ratings are below his personal ratings as President. A majority of those polled were concerned about the rising budget deficits. BUt his ratings among Republicans has fallen from 44% in February to 23%. Republicans were viewed favorably by only 285 of those polled, the lowest ever.

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Friedman reviews Acemoglu and Robinson's new book, "Why Nations Fail." Acemoglu says that nations fail when wealth and opportunities are concentrated in the hands of few people, that a condition for societies to succeed is to create opportunities for more people. For this to happen it is important to create inclusive political and economic institutions. This is an important insight, but for Western society this is an insight as old as Adam Smith when he pointed out the importance of this aspect of western societies after the feudal period in his "Wealth of Nations." For Smith it was the failure to create inclusive societies that led to the gradual unravelling of societies in the river valleys of the Yangste and the Ganges, in China and India, of increasing poverty and the gradual disappearance of what constituted the middle class in India and China. Chapter 8 titled "Of Wages and Labor" in the "Wealth of Nations" makes specific reference to this.

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The Bernanke Fed's low interest rates are hurting seniors and savers who are earning very little on their savings. This is taking money away from millions of savers and reducing consumption spending by seniors and savers. According to the Labor Department average annual investment income for 24.6 million American households headed by seniors over the age of 65 was $2,564 in 2009. This is down significantly from prior years. A survey by the Employee Benefit Research Institute shows that one in three retirees have had to dig deeper into their savings to cover basic necessities in 2010. With inflation at an annualized rate of 5.6% in the first quarter 2011, interest rates of 0.24% on savings accounts do little to cover inflation. There is a sense that this is hurting retirees who have lived prudently and worked hard and on savers of different ages. This actually discourages healthy savings that would protect Americans from job losses and build a safer future. American contributions to bank and 401 (k) accounts is only 4% of disposable income in 2010, according to the Fed. Another danger is that the smaller 401 (k) accounts of the average American family after losses in earlier stock market declines, will again be exposed to the fluctuations and risk in the stock market. This could happen as money is shifted to the stock market in the hope of earning better returns. Seniors are an active voting group, and voting patterns show a shift to Congressional candidates who question Fed policy....

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The percentage of Americans snacking more than 3 times a day increased to 56% by 2010, according to government data. This was at 20% in the 1990's and 10% in the 1970's. And with this comes higher rates of obesity, as this has made for unhealthy eating and reduced the number of healthy meals. 48% of Americans skip meals 3 times a week and 53% decide what to eat for a meal less than an hour before eating, according to a Hartman Group survey. Not all snacks are unhealthy as food companies are introducing healthier snacks than before. The discipline of earlier generations for having a healthy meal at meal times has eroded with single person households, two career families, and the generally hectic pace of life.

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ESPN television network sports reporter Allison Williams leaves ESPN after refusing to follow ESPN's vaccine mandate because of fertility concerns. She starts a sports series at the conservative Daily Wire which advertises her series as "sports without the woke." Woke started out as a term for black people who felt marginalized, but has changed meanings several times and is a classic example of how meanings change with internet use. Woke now also means people who feel they are being discriminated against for their views. Mrs Williams, 37 years old, says she wants a second child and is concerned that this could affect her fertility or her pregnancy, according to an earlier interview with WSJ.  How the vaccine mandate and companies implementing the vaccine mandate handle it to accomodate concerns of this kind will be a test of its effectiveness and perceptions about its sensitivity to human concerns beyond politics. For people with health concerns new solutions are needed. Abraham Lincoln faced a similar situation after the civil war that Biden faces today and there is much to be learned from his words- "with malice towards none, with charity for all," to bring together all Americans.    ...

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The economist argues that home ownership is not benficial as social policy as it was made out to be. People in negative equity, or holding subprime mortgages, or people in foreclosure with blighted neighborhoods and acceleration in falling prices, and the lack of mobility that comes with home ownership in states that have high home ownership, and disappearing wealth with falling prices, make it a poor tool of social policy and a failed way of accumulating wealth. Experts say that one in four recesssions are caused by housing market collapse, and these recessions take longer to heal. The heavy borrowing against home equity of $9 trillion between 1997 and 2006- equal to more than 90% of disposable income- also makes this inr reality a way of adding debt not of accumulating wealth, as the wealth has an illusory aspect when prices are pushed up by the constant trading of homes as investments setting up a bubble phenomena, and renters who do not have what it takes to own a home are pushed into home ownership. About 10 million homeowners have negative equity in their homes. The value of American homeowners equity has dropped from the peak of $12.5 trillion in 2005 to just $8.5 trillion at the end of 2008. All that $9 trillion in debt is piled up against illusory gains in wealth based on transitory house price jumps. These numbers suggest that the $9 trillion in debt from borrowing aginst home equity is more than the entire value of homeowner equity in the USA, meaning if Americans had aliquid market and sold all their homes today they could not pay off the debt generated from home equity borrowing during the bubble years. Worse still cutbacks in consumption are severe in such situations, and this situation weakens banks balance sheets as foreclosures increase, creating a vicious cycle and downward trend as investment and employment are also hit hard, one that is hard to break....

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U.S. states want flexibility in applying the Medicaid program which covers 53 million Americans earning lower levels of income. This amount was $11,616 a year for working parents in 2009, according to the Kaiser Fondation. Some states have a higher income level, as high as $48,400. The problem for states are serious budget deficits, with Medicaid comparing with education as a major cost. The recession and job losses has added 8 million Americans to Medicaid rolls. The Federal government supports 57% of the Meddicaid budget on average. A provision in the 2010 health care law says states cannot limit Medicaid eligibility, or they would lose funding by the federal government. The Obama adminstration's position is that eligibility or provider cuts will not bring in large savings, and will allow larger cost-sharing by Medicaid users, with only minor cuts in eligibility. Its position is also that the law does not give the federal government waiver authority. Some of the issues raised relate to the structure of Medicaid cost and its rapid escalation. Health and Human Services says 1% of benificiaries, especially the long term care, use up 25% of the Medicaid expenditures. One astonishing fact is that two thirds of all U.S. nursing home residents are on Medicaid. The total cost is rising, from $187 billion for Medicaid in 2000, to $346 billion in 2009, according to the Centers for Medicare and Medicaid Services. In July 2011, $26 billion in additional federal Medicaid funding expires, which will be added to state expenses as they struggle with large deficits. In states like Maine, with generous benefits, about one fourth of all residents are in the Medicaid program. ...