The sustainability of public sector pension plans is an issue of great fiscal concern for state and local governments in the United States. According to government reports, state public sector pension plans confront a total unfunded liability of $842 billion. Underfunding of this magnitude presents a serious fiscal problem for individual governments and will require a growing amount of budgetary resources to fund benefit promises to retired workers.

This paper proposes a methodology for evaluating the operation and success of state government streamlining commissions. These commissions—typically appointed by governors or state legislatures—became increasingly popular in the last decade as a way to identify potential savings in state government by reducing redundancies and increasing efficiencies in state spending. Such changes contribute to creating a more business-friendly environment in states resulting in increased state competitiveness in economic development.

The U.S. economy has not been healthy since 2001 when 9/11 pushed the country into a recession. As the accompanying data tell us, real GDP growth has risen to meet the long-term average of 3.11 percent just once since 2001, and that was in 2004. The combination of wars, financial collapse, natural disasters, and political games has taken a heavy toll on economic growth. No one is talking about 3 percent or better growth anytime in the foreseeable future. But it’s not just about Democrats and Republicans. It’s about something deep in the economy.

Fiscal policy at both the federal and state levels is on an unsustainable path. Entitlement reform in America—particularly Medicaid reform—is shifting from a question of whether cuts should be made, to how much must be cut? To better understand best practices in Medicaid reform, we explore five recent state-level Medicaid reforms and their ability to simultaneously reduce costs, maintain or increase access, and survive the politics of reform.