Washington, DC, USA. The easiest way for a state to trim Medicaid costs is to cut back on reimbursements to doctors and hospitals. But there’s already a shortage of primary care, and further cuts could make it worse.

At least 33 states have reduced the allowable provider fees for the fiscal year that starts on 1 July, according to a report by the National Association of Budget Officers.

Washington, DC, USA. Because strong evidence indicates that policies beyond the health sector have substantial effects on people's health, all levels of U.S. government should adopt a structured approach to considering the health effects of any major legislation or regulation, says a new report by the Institute of Medicine (IOM).

In addition, federal and state policymakers should review and revise public health laws so that they adequately address current health challenges.