ABSTRACT
The implementation of Medicaid was quite different. In some respects Medicaid was a new program; but in others, it was merely an extension of what was going on before. If Congress and the federal bureaucracy failed to provide appropriate manpower to cope with Title XIX, the states, smelling easy federal money under the new Title, began putting on the pressure for implementation. California and New York provide massive case studies of the implementation of different elements of federal rhetoric: the one in terms of "comprehensive care" and equality of services; the other in terms of defining the potential scope of "medical indigency." New York, it is true, did not move as fast as California. But when it did, its program was equally significant. New York already had a relatively comprehensive although sometimes erratic array of health benefits available through state programs to welfare recipients and the elderly "medically indigent.".
