Medicaid underfunded the actual cost of long term care this year by a total of $4.2 billion, a new study estimates.

The states with the worst cases of Medicaid nursing facility underpayments are New York, with $548 million in underfunding, and Illinois, with $379 million in underfunding, analysts at Eljay L.L.C., Louisville, Ky., report in a study commissioned by the American Health Care Association, Washington.

The gap is largely the result of rising costs, the analysts conclude.

The AHCA says the analysis shows that the federal government should include relief for state Medicaid programs in any economic stimulus package.