The NYT reported last Thursday that Arizona--facing a large budget deficit--is the first state to completely eliminate its Children's Health Insurance Program, eliminating coverage for 47,000 low income children. The state will also roll back Medicaid coverage for childless adults, which will eliminate health insurance for 310,000.

State leaders said they were left with few choices because of a $2.6 billion projected shortfall next year. But hospital officials and advocates for low-income people said they were worried that emergency rooms would be overrun by patients who had few other options for care, and that children might suffer enduring developmental problems because of inadequate medical attention.

The cuts also mean the state will forgo hundreds of millions of dollars in federal matching aid, and could lose far more if Congress passes a health bill that requires states to maintain eligibility levels for the two programs.

Ms. Brewer, a Republican, has warned that more cuts will be needed if voters do not approve a referendum in May to raise the sales tax by a penny for three years, to 6.6 cents per dollar.

I don't think Arizona will be the last state to do this. The fiscal situation facing the states--including my home state of California--is dire.