An Unsustainable Path: The Past and Future of Kentucky Medicaid Spending

Published June 1, 2011

John Garen, professor in economics at the University of Kentucky and adjunct scholar at the Bluegrass Institute, writes an extensive study on the expansion of Medicaid in his state.

  • From 1999 to 2009, total federal and state spending on Kentucky’s Medicaid program rose by 54%, from $3.3 billion to $5.1 billion and Kentucky’s general fund spending on Medicaid increased by 37%, from $802 million to $1.1 billion
  • The number of Kentuckians enrolled in the program grew from about 664,000 to roughly 924,000, or 39%.
  • These increases occurred during a time where real U.S. GDP grew by 19% and Kentucky’s by only 8% and followed a decade (1989 to 1999) of even more dramatic increases in the Medicaid program.

Read a transcript of an interview with John Garen at