Medicaid spending ranked by share of state budgets

By Jakob Emerson / January 14, 2025

Texas has the highest Medicaid spending as a percentage of total state expenditures, while Wyoming has the lowest, according to KFF.

The data is from states' fiscal year 2023 and excludes administrative costs, but includes spending from state funds, federal funds and other revenue sources such as provider taxes, fees, assessments, donations, and local funds. Medicare Part D clawback payments are also included.

Medicaid spending as a share of state budgets:

1. Texas: 42%

2. Missouri: 41%

3. Pennsylvania: 40%

4. Ohio: 39%

5. Louisiana: 38%

6. New York: 38%

7. Colorado: 36%

8. New Mexico: 34%

9. Oklahoma: 34%

10. Idaho: 33%

11. Indiana: 33%

12. Kentucky: 33%

13. Minnesota: 33%

14. California: 32%

15. Maine: 32%

16. Nevada: 32%

17. Florida: 31%

18. New Hampshire: 31%

19. North Carolina: 31%

20. Tennessee: 31%

21. United States: 30%

22. Massachusetts: 30%

23. Arkansas: 29%

24. Michigan: 29%

25. Virginia: 28%

26. Oregon: 27%

27. Iowa: 26%

28. Rhode Island: 26%

29. Vermont: 26%

30. Washington: 26%

31. Mississippi: 25%

32. New Jersey: 25%

33. Connecticut: 24%

34. Arizona: 23%

35. Georgia: 23%

36. Kansas: 23%

37. Montana: 23%

38. Nebraska: 23%

39. West Virginia: 23%

40. Alabama: 22%

41. South Carolina: 22%

42. Wisconsin: 22%

43. Delaware: 21%

44. Maryland: 21%

45. Utah: 20%

46. North Dakota: 19%

47. South Dakota: 19%

48. Alaska: 17%

49. Hawaii: 17%

50. Illinois: 17%

51. Wyoming: 13%