The latest annual survey of Medicaid directors from the Kaiser Commission on Medicaid and the Uninsured shows increased demand for Medicaid.

There's no surprise in a write-up of the report provided by Stateline.org, which provides some quotes from various officials--except perhaps that it says nothing about employment. In our employment-based system of health insurance, a drop in employment will automatically translate into a drop in insurance coverage.

And given the high price of insurance--made high by state mandates on individual policies and the whole tax system-induced cost-shifting that goes on--a decline in employment-based coverage is going to result in more demands on Medicaid.

The Stateline article mentions several steps that officials in the states are pursuing. Not on the docket, if the state of Washington is any indication, is trimming enrollment. The ethic that says "enroll as many people as possible" thus leads to meager reimbursement rates for physicians and other medical professionals and service cuts to existing beneficiaries. It also takes pressure off of making reforms to the insurance and health care markets to reduce costs through regulatory reforms such as letting people buy insurance across state lines and repealing certificate of need laws.