The Pew Charitable Trusts

TODAY'S TAKE: The recession is forcing more Americans to turn to Medicaid, the vast state-federal health insurance program for the poor. But as states struggle to meet the rising demand, doctors and other health care providers are being paid less and patients' choices are being restricted - if they are covered at all anymore.

The last time intercity passenger trains served Madison, Wisconsin's capital city, students at the University of Wisconsin campus there were protesting the Vietnam War. The trains stopped running when Amtrak took over passenger service around the country in 1971. But last month, the federal government announced it would give the state $810 million in stimulus money to return passenger trains to Wisconsin's second-biggest city for the first time in more than four decades.The $8 billion in federal stimulus money billed as "high-speed rail" funding that will pay for the Wisconsin improvements is going to 31 states to improve service on trains of all speeds. But as even the straightforward case of Wisconsin shows, the path for states to actually build high-speed rail promises to be long, costly and, in some cases, politically contentious.

TODAY'S TAKE: The fiscal year that begins in July for most states will be "the most difficult to date," according to a survey of 45 states released at the winter meeting of the National Governors Association.