In this Press-Enterprise (Riverside, California) commentary, John Holahan explains that Medicaid has done a good job of keeping costs under control and that its increase in spending is caused by the swelling number of enrollees, particularly in a weak economy. The 7 million people eligible for both Medicaid and Medicare are not dealt with in a cost-effective way, though, and transferring responsibility for them to the federal government would pave the way for health reform.