At the municipal level, things have been stretched since the boom days in 2004, 2005. Most of them have laws that make it very hard to raise taxes, a pay struc

At the municipal level, things have been stretched since the boom days in 2004, 2005. Most of them have laws that make it very hard to raise taxes, a pay structure that historically has slanted towards better benefits in exchange for lower pay, and a 10-year run of health insurance cost increases at 10-15% a year. So in many places, they've already cut to the bone, (and did so during the "boom years", to boot). Basically the best thing we can do for municipalities and states is to bend that healthcare cost curve. Unless we do, it's going to be lay people off, raise taxes or both every single year.