Medicaid represented the largest single category of state spending, consuming an estimated 21.9% of state budgets in fiscal 2004, according to a report by State Coverage Initiatives, which tracks state efforts to expand healthcare coverage. By comparison, elementary and secondary education -- the largest category during the five years from 1999 to 2003 -- represented 21.5% of state expenditures in fiscal 2004, and higher education accounted for 10.5%. Meanwhile, in recent months, many states were trying new ways to expand health insurance coverage, amid a growing number of uninsured, rising healthcare costs, uncertainties related to the 2006 federal budget and effects of the 2005 hurricane season. State efforts included both Medicaid expansions and market-based strategies, such as a small-business initiative in West Virginia. States also "developed a new twist on mandating coverage, with Maryland passing legislation to require employers to pay their 'fair share' and Massachusetts considering an individual mandate," the group said in the report. Read the report. -- by Jessica Zigmond
Medicaid was largest 2004 state budget item: report
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