Image of male nurse pushing senior woman in a wheelchair in nursing facility

Medicaid has retained it’s No. 1 spot on states’ spending lists, gobbling up an estimated 21.9% of state spending in fiscal 2004, a new report says.

That was the largest chunk of state spending that year, according to State Coverage Initiatives, which follows efforts by states to expand healthcare coverage. Elementary and secondary education represented 21.5% of state expenditures in 2004. Higher education accounted for 10.5%.

States in recent months have been trying to find new ways to expand health insurance coverage, the report said. Such efforts included Medicaid expansions and market-based strategies.