Medicaid enrollment declines.

Enrollment in Medicaid declined in 2007 for the first time in nearly a decade, primarily because new documentation requirements have caused significant delays in processing applications and because the strong economy and lower unemployment have reduced enrollment, according to a new 50-state survey from the Kaiser Family Foundation. But states expect enrollment and spending to increase in 2008 as they move forward with program enhancements, according to the survey. "States are turning to Medicaid to address the rising number of uninsured to help fill in the gaps for low-income families," Diane Rowland, executive vice president of the Kaiser Family Foundation, said in a statement. With the nation's growing uninsured population, 42 states report efforts to expand coverage for the uninsured using Medicaid as a financing vehicle. In addition, every state implemented at least one provider payment increase in 2007, and almost all the states have adopted an increase for 2008.