These States Spend the Most Taxpayer Dollars on Medicaid

How much does the U.S. spend on health care each year? In 2016 alone, the government devoted $3.4 trillion of taxpayer funds to the cause, with an average health care cost of $10,348 per person.

Even American military spending, on track to top $800 billion for military ground vehicles, planes, and maybe a few parades in 2018, doesn’t come close.

According to the Congressional Budget Office (CBO), Medicare represents 15% of the overall federal budget. Medicaid, at 10% of spending, is not far behind. If you live in one of the states with the poorest population, you don’t have to look beyond these costs to see where the money is going.

These states spend the most on health care for the poor in America.

15. Indiana

Indianapolis skyline at sunset

Indiana is adding Medicaid work requirements. | RudyBalasko/iStock/Getty Images

  • Total Medicaid spending: $10.9 billion

Indiana, the home state of Vice President Mike Pence, checks in at nearly $11 billion. The overwhelming majority of that money — 71% of Indiana’s Medicaid funds — came from the federal government.

As for the $3.1 billion coming from the state, Indiana will try to reduce that with Medicaid work requirements in 2018. Until then, The Hoosier State joins the list of states that receive the most government assistance.

Next: This desert state combines a high number of uninsured and a huge Medicaid expenditure.

14. Arizona

Mesa, Arizona

The federal government picks up most of the Medicaid tab in Arizona. | RobertSilberblatt/iStock/Getty Images

  • Total Medicaid spending: $11.34 billion

Arizona has a lot in common with Indiana. Both participated in the Obamacare Medicaid expansion, and both rank in the bottom half among states for rate of insured, according to WalletHub.

Meanwhile, both crack the top 15 in Medicaid spending, with most coming from the federal government. Arizona is just a little harder on taxpayers, with $11.34 billion in costs. Some 75% of that amount came from D.C.

Next: This state’s Medicaid spending is proportional to its population.

13. Washington

Spokane, Washington

Medicaid spending in Washington is high. | csfotoimages/iStock/Getty Images

  • Total Medicaid spending: $11.46 billion

For a state with the 13th highest population, you might say Washington’s Medicaid spending is as high as you expect. At last count, it totaled almost $11.5 billion, with 62% coming from the federal government.

You might argue this taxpayer burden is high even considering Washington’s population. That’s probably true, but until the cost of prescription drugs and other factors get under control, no one stands a chance.

Next: For a state ranked 21st in population, its Medicaid count looms large.

12. Minnesota

Downtown Minneapolis skyline with the Walker Art Center

Minnesota’s population isn’t huge, but it’s healthcare bill is. | YinYang/iStock/Getty Images

  • Total Medicaid spending: $11.54 billion

At 5.4 million people, Minnesota didn’t crack the 20 most populated states in the 2013 census. However, it’s among the highest in Medicaid spending at $11.54 billion.

Some 58% of that amount came from federal taxpayer dollars.

Next: This Southeastern state spends big yet still has legions of uninsured.

11. North Carolina

Greensboro, North Carolina, USA

North Carolina spends nearly $13 billion on health care for the poor. | Pavone

  • Total Medicaid spending: $12.82 billion

Even without Medicaid expansion, North Carolina came near the top 10 in spending on health care for the poor. In 2016, the number was just south of $13 billion, with 66% coming from the federal government.

North Carolina ranks 10th in population. However, looking at its rate of insured (42nd), the state is lagging behind the pack.

Next: This state’s dense population and poor urban centers make it a candidate for high Medicaid costs.

10. New Jersey

The skyline and Atlantic Ocean New Jersey.

Federal taxpayers pay the bulk of New Jersey’s Medicaid bill. | AppalachianViews/iStock/Getty Images

  • Total Medicaid spending: $15.08

Departed New Jersey Governor Chris Christie used to point out how taxpayers gave much more than they got from the federal government.

While that is mostly true, federal taxpayers contributed more (57%) to New Jersey Medicaid recipients than the state. Overall, the program costs Jersey more than $15 billion.

Next: This state boasted a modest Medicaid success story.

9. Michigan

The Detroit skyline.

Medicaid expansion may have helped more people in Michigan get jobs. |

  • Total Medicaid spending: $17.44 billion

In Michigan, there was some success with the state’s Medicaid expansion. According to a University of Michigan study, over half those who received benefits said the program helped their job search.

Nonetheless, the price tag remains exorbitant at $17.44 billion in a single year. Seventy-three percent of those funds came from federal taxpayer dollars.

Next: This state is among the wealthiest and has the lowest rate of uninsured.

8. Massachusetts

Worcester, Massachusetts, USA

Massachusetts is one of the richest states in America. | Sean Pavone/iStock/Getty Images

  • Total Medicaid spending: $17.86 billion

In terms of wealth, you’ll always find Massachusetts ranking in the top five richest states. It also boasts the lowest rate of uninsured citizens in America.

However, that comes at a steep cost: $17.86 billion. Since MassHealth picks up a big chunk of the tab, just 54% of that amount came from state tax dollars.

Next: A high percentage of people on food stamps combines with high Medicaid spending here.

7. Illinois

The state capitol building in Springfield, Illinois.

Illinois spends more than $20 billion on Medicaid every year. | fotoguy22/iStock/Getty Images

  • Total Medicaid spending: $20.17 billion

While the 1.9 million Illinois residents were on food stamps in 2016, the expense ($224 million) was trifling compared to the cost of health care for the poor.

The Medicaid bill came to $20.17 billion, about 60% of which came from federal tax money.

Next: This state’s Medicaid expansion was pricey for taxpayers.

6. Ohio

Cincinnati downtown early in the night

More people in Ohio have health insurance, but that’s increased Medicaid spending. | AndreyKrav/iStock/Getty Images

  • Total Medicaid spending: $22.39 billion

The uninsured ranks have shrunk since Ohio adopted the Medicaid expansion, but it has come at a heavy price to state and local taxpayers.

In 2016, the total tab came to $22.39 billion, with some 69% coming from the federal government.

Next: This state has the most people on food stamps and a $22.5 billion Medicaid tab.

5. Florida

Palm trees at sunrise in Hollywood, Florida

The federal government covers 61% of Florida’s Medicaid bill. | typhoonski/iStock/Getty Images

  • Total Medicaid spending: $22.46 billion

While Florida has over 3.1 million residents on food stamps, those costs ($380 million) haven’t come close to the tab for health care.

According to the data, well over $22 billion went to Medicaid spending in 2016, with 61% coming via federal tax dollars.

Next: This state’s large homeless population contribute to swelling Medicaid ranks.

4. Pennsylvania

Pennsylvania Farmland With Rainy Sky

Federal taxpayers paid $11.2 billion of Pennsylvania’s Medicaid costs. | Maksymowicz/Getty Images

  • Total Medicaid spending: $28.2 billion

As the sixth-largest state in America, you have to expect high health care costs for the poor in Pennsylvania. However, the $28.2 billion the state spent in 2016 exceeds that.

All told, 60% ($11.2 billion) came from federal taxpayer funds. Philadelphia’s large homeless population did not help.

Next: The state with the highest rate of uninsured in America has a Medicaid spending problem, too.

3. Texas

Houston, Texas, USA

Texas has the highest rate of uninsured people in the U.S. | Sean Pavone/iStock/Getty Images

  • Total Medicaid spending: $41.07  billion

Out of all the states in the Union, Texas had the highest rate of uninsured, according to WalletHub data. Nearly 25% of low-income households lacked health insurance in 2016.

Nonetheless, the state’s Medicaid ranks remained unsustainable despite the governor declining Medicaid expansion. Spending to insure the poorest Texans hit $41.07 billion, with 58% coming from the federal government.

Next: Where America’s biggest city and its largest homeless population converge, state health care costs are out of control.

2. New York

Downtown Buffalo New York City Hall Sunny Day

More than half of New York’s Medicaid spending comes from the state.| Miklmar/iStock/Getty Images

  • Total Medicaid spending: $62.9 billion

Not only does New York City have the highest homeless population in America; it also is the nation’s largest city. These factors typically lead to high Medicaid rolls, and the costs are staggering.

Overall, the program cost $62.9 billion in 2016. Some 55% — much higher than the average — came from state funds.

Next: California has the most of everything in America, including Medicaid costs.

1. California

oakland california

California spends close to $90 billion on Medicaid. | trekandshoot/iStock/Getty Images Plus

  • Total Medicaid spending: $88.7 billion

Even taking California’s massive population and top-six economy (worldwide), the state’s nearly $90 billion in Medicaid spending is staggering to behold.

In 2016, some 64% of that amount ($56 billion) came from federal tax dollars.

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