State Data Lab Enables Legislators to Easily — and Graphically — See States’ Budget Situations

Published March 19, 2014

Every year, legislators are challenged with spending trade-offs during budget season. Medicaid growth is typically one of these challenges. To understand the situation and assess alternatives, legislators need easily available, clear, understandable information. Truth in Accounting (TIA) has created a web site — — to help legislators quickly find information using a simple graphics tool. Selecting “Create Your Own Chart” on the home page offers a graphic access to a variety of information and context related to spending history and the financial position for all 50 states.

Here are some questions a legislator might ask, and simple graphic answers from Each graph takes less than a minute to create, and is easy to share, with a unique “perma-link” or by printing or downloading results.      

  • What are Medicaid spending trends in my state, compared to the US average? 

This chart: shows Medicaid spending for California versus the US average. California’s Medicaid spending more than doubled since 1997, with a notable spike in 2011. The US average did not quite double during that time. To see a different state, select “Edit Chart Criteria” and change the state selection on the next page, then “Create a New Graph.”

  • How has Medicaid enrollment grown in my state compared to Medicaid spending? California Medicaid enrollment grew from 5.04 million in 2000 to 7.37 million in 2011 while spending grew from $21.4 billion to $54.9 billion during that time. View any other state by selecting “Edit Chart Criteria,” selecting a different state on the next page, then “Create a new Graph.”

  • What share of my state’s population participates in Medicaid, compared to the US average?

California’s Medicaid share of population increased from 14.8% in 2000 to 19.5% in 2011. The US average increased from 10.7% in 2000 to 15.9% in 2011.       

  • What share of doctors in my state will accept new Medicaid patients, compared to the US average?

In 2011, 57.1% of California doctors accepted new Medicaid patients, compared to the US average of 75.7%

  • What are yearly spending trends for health and human services in my state since 2005?

Total California expenses for health and human services increased every year since 2005, except for 2012. Net expenses decreased in 2009 and 2010 and then increased in 2011 and 2012. (Net expenses are total expenses with fees and contributions subtracted, for example, after federal government reimbursement).  

  • How do these health and human services expenses compare to other key expenses? California net expenses for health and human services declined in 2009 and 2010, and have increased in 2011 and 2012. Net education expenses were highest in 2008. 

  • What is my state’s overall financial position (assets vs liabilities)? How does it compare to others in percent of “outbound moves,” unemployment, timely reporting and other factors? 

California’s state page, available by clicking CA on the home page map, is at The chart on the lower left summarizes Truth in Accounting’s unique, holistic asset/liability analysis. Debt remaining per taxpayer after available assets are tapped is the “Taxpayer Burden,” $22,100 for 2012. On the upper right a graph shows 2009-2012 history. Other interesting facts on the page show the percent of average California income required to pay the Taxpayer Burden (47.5%), percent of outbound moves (45.93%), reporting timeliness, unemployment rate, and more. 

  • How does my state’s overall financial position affect doctors’ willingness to accept new Medicaid patients? 

One of the weekly “featured charts” at shows states with higher debt (Taxpayer Burden) have fewer doctors willing to accept new Medicaid patients. Debt is not just a number; it affects quality of services provided to the needy. (Sinkhole states have the highest debt per taxpayer after available assets are tapped; Sunshine states are those with enough assets to cover their debt. Only seven states are “Sunshine States” at fiscal year-end 2012)

States are the laboratories of democracy.  State Data Lab can help legislators – and their constituents – better understand what’s going on inside those labs. 

Donna Rook ([email protected]) is president of, a project of Truth in Accounting.