Fiscal pressure and demand for government healthcare has left virtually every state making or considering substantial cuts in Medicaid, even as Democrats push to add 15 million people to the rolls, the New York Times reports. States are temporarily barred from reducing eligibility, so they have been left to cut "optional benefits," like dental and vision care, and reduce payments to doctors and other healthcare providers. In some states, governors are trying to avoid the deepest cuts by pushing for increases in tobacco taxes or new levies on hospitals and doctors, the Times reports.