State Medicaid programs are facing significant financial challenges in the coming years.

Among them:  less federal Medicaid matching money, a continued call by providers for increased payments, and a growing demand to use Medicaid to help address behavioral health challenges.

In addition, proponents of investing more Medicaid money in home- and community-based services can be expected to ask state Medicaid programs to cover more services while those programs face a growing demand to use Medicaid resources to address social determinants of health such as poor housing and hunger.

At the same time, large numbers of individuals continue to fall off the Medicaid rolls as the Medicaid unwinding process continues, possibly placing pressure on states to find ways to help the newly uninsured.Meanwhile, states appear to be facing a slowdown of tax revenue, which would place even greater pressure on their Medicaid spending.

These conditions could pose special hazards for community safety-net hospitals like those that are part of the Alliance of Safety-Net Hospitals because those hospitals care for more low-income, Medicaid-covered, and uninsured patients than the typical American hospital and are far more dependent on Medicaid payments than most hospitals.

Learn more about the challenges in the offing for state Medicaid programs from the KFF Health News column “The Shifting Sands for State Medicaid Programs Lurking in Our Data.”