Unfortunately the deficits are real, as are state budgets. As a result, there must be some give and take. In order to reduce expenses Medicaid will have to be revamped so that it serves only the truly poor. Also, consumers already on Medicaid should be given strong financial incentives to buy reasonably priced Medicaid insurance plans. This way, the state is saving money while individuals are still insured. Finally, states need to be given block grants for Medicaid so that they can decide what their appropriate areas of need are.