Medicaid spending in the South increased by an estimated 237% between fiscal 1988 and 1994, to $47.9 billion from $14.2 billion, according to a recent study conducted by the Southern Legislative Conference.

On an annualized basis, the growth rate was 23%.

Among the 16 states covered by the conference, Louisiana experienced the greatest increase in Medicaid spending during the period, with a 362% gain. Oklahoma had the smallest increase, at 90%. After Louisiana, the five states with the largest increases were: Texas, 299%; West Virginia, 298%; Florida, 292%; Alabama, 267%; and South Carolina, 263%.

The trend could have a serious fiscal impact on the budgets of the Southern states, according to the report.

"States in the region generally have a greater number of low-income populations and a limited ability to finance health care programs at the high levels found in other parts of the nation," the report said.

"Therefore, federal mandates such as coverage of pregnant women and children to 133 per cent of the federal poverty level would have more farreaching effects in most southern states than it would in a relatively wealthy state with already generous eligibility standards and a small indigent population."

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