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The argument of some state policymakers, says Michael Sparer, PhD, JD, department chair and professor of health policy and management at Columbia University's Mailman School of Public Health in New York City, is that the federal government is significantly increasing its oversight of the Medicaid program and its demands on state Medicaid officials; "and they believe strongly that that's the wrong way to go."

Battles will continue, over both Medicaid expansion and the mandate