State Medicaid programs have been struggling as the worsening economy resulted in lower tax revenues, combined with growing enrollment and costs as the safety net for the newly jobless. Expansion of Medicaid under ACA only serves to increase the strain. States that were already reliant on managed care plans will likely increase their reliance as they seek the capacity to meet the increased demand for medical services of all types. What is the result on individual states of trying to raise the taxes to fund each of their Medicaid programs? What alternatives do the states have to fund their Medicaid programs? Explain your answer.