Now we await the ending of the story: if the block-granting of Medicaid becomes a reality, what will happen to the current Medicaid-dependent mental health system? It is likely that block-granting will underestimate future Medicaid costs (as previous block-grant proposals did) and will leave states with the choice of picking up the cost difference themselves, or allowing services to be underfunded. Underfunding can result in fewer—or lower quality—services being offered and fewer individuals being served. No matter how the states proceed, it is unlikely that the private providers will want to stay in the "business" without unrestricted Medicaid funding, which raises the question of whether the states can reassemble the non-Medicaid-dependent service systems that they dismantled. The other, more likely, possibility is that they will simply abandon people with major mental illness to ruined systems. We await the conclusion of this story with great concern.