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Fully maximizing what is available from the federal government to support the Safety Net Care Pool, SCHIP, or other areas of Medicaid expansion is likely to take some new state revenues. But doing so will also permit the state to use federal dollars to cover a significant portion of the costs of expanding coverage to the uninsured. This paper clarifies the options the state has in pursuing federal revenue. This paper also outlines the forthcoming changes in patterns of federal reimbursement that are a product of recent negotiations over Massachusetts's Medicaid waiver program. (Roadmap to Coverage, October 7, 2005)