State Health Care Spending Project

When it comes to health care spending, the bill just keeps getting bigger. Health care’s growing claim on state budgets is competing with other important priorities, including education, public safety, and transportation.

Medicaid is now the top budget item for states, comprising more than 22 percent of their total spending in fiscal year 2010, and that figure is projected to rise in coming years. Many states will spend more money on Medicaid as the Affordable Care Act (ACA) begins to expand in 2014—and that amount will grow in 2019, when federal funds begin to taper. The implementation of ACA has heightened the focus on Medicaid. But states have many other health care costs—such as public sector employee and retiree benefits, public health, state-run hospitals, and corrections—that account for a significant share of their overall health care spending. Containing all of these costs in ways that deliver better outcomes will be critical to states’ fiscal health now and in the future.

The State Health Care Spending Project conducts original research, convenes policy makers, and works with experts in the field to help states understand how much they spend on health care overall, how that amount has changed over time, what is driving it higher, and which policy approaches are containing costs while improving health outcomes.

The State Health Care Spending Project is a joint initiative of the Pew Center on the States and the John D. and Catherine T. MacArthur Foundation.

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