The Grant Machine: $769.2 billion to States & Organizations

Where federal grant money actually goes — and why most of it is Medicaid.

The big reveal: Most federal "grants" are actually Medicaid transfers to states. California's Department of Health Care Services alone receives $112.5 billion — more than the entire budgets of most countries. The top 10 recipients are all state health agencies.

Medicaid

$676.8 billion

39 recipients · 88% of total

Other

$38.4 billion

3 recipients · 5% of total

Transportation

$27.4 billion

3 recipients · 4% of total

Education

$16.1 billion

3 recipients · 2% of total

Emergency Services

$10.5 billion

2 recipients · 1% of total

Top 20 Grant Recipients

Medicaid

Education

Transportation

Emergency Services

Other

All 50 Recipients

#	Recipient	Amount↓	Category
1	HEALTH CARE SERVICES, CALIFORNIA DEPARTMENT OF	$112.5B	Medicaid
2	NYS DEPARTMENT OF HEALTH	$76.5B	Medicaid
3	HEALTH & HUMAN SVC COMMN TX	$33.8B	Medicaid
4	PA DEPARTMENT OF HUMAN SERVICES	$32.3B	Medicaid
5	NORTH CAROLINA DEPARTMENT OF HEALTH & HUMAN SERVICES	$28.5B	Medicaid
6	OHIO DEPARTMENT OF MEDICAID	$27.7B	Medicaid
7	FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION	$22.8B	Medicaid
8	ILLINOIS DEPARTMENT OF HEALTHCARE & FAMILY SERVICES	$21.8B	Medicaid
9	MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES	$21.7B	Medicaid
10	HUMAN SERVICES, NEW JERSEY DEPARTMENT OF	$18.4B	Medicaid
11	VA DEPARTMENT OF MEDICAL ASSISTANCE SERVICE	$17.2B	Medicaid
12	HEALTH SERVICES KENTUCKY CABINET FOR	$17.1B	Medicaid
13	THE COMMONWEALTH OF MASSACHUSETTS	$16.8B	Other
14	INDIANA FAMILY AND SOCIAL SERV	$16.7B	Medicaid
15	ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM	$16.4B	Medicaid
16	NATIONAL RAILROAD PASSENGER CORPORATION	$15.2B	Transportation
17	LOUSIANA DEPARTMENT OF HEALTH	$14.6B	Medicaid
18	DEPARTMENT OF SOCIAL & HEALTH SERVICES	$14.0B	Medicaid
19	OREGON HEALTH AUTHORITY	$13.9B	Medicaid
20	MINNESOTA DEPARTMENT OF HUMAN SERVICES	$13.1B	Medicaid
21	DEPARTMENT OF SOCIAL SERVICES MISSO	$13.0B	Medicaid
22	GEORGIA DEPARTMENT OF COMMUNITY HEALTH	$13.0B	Medicaid
23	FINANCE & ADMINISTRATION TENNESSEE DEPAR	$11.9B	Other
24	MARYLAND DEPARTMENT OF HEALTH	$11.8B	Medicaid
25	STATE OF COLORADO - DEPT OF HEALTH CARE POLICY & FINANCING	$10.0B	Medicaid
26	STATE OF WISCONSIN DEPARTMENT OF HEALTH SERVICES	$9.8B	Medicaid
27	GOVERNMENT OF THE VIRGIN ISLANDS	$9.7B	Other
28	DEPARTMENT OF SOCIAL SERVICES CALIFORNIA	$9.5B	Medicaid
29	DEPARTMENT OF HUMAN SERVICES NEW MEXICO	$8.6B	Medicaid
30	OKLAHOMA HEALTH CARE AUTHORITY	$7.9B	Medicaid
31	DEPARTMENT OF SOCIAL SERVICES CONNECTICUT	$7.8B	Medicaid
32	DEPARTMENT OF HEALTH HUMAN SERVICES	$7.7B	Medicaid
33	DEPARTMENT OF EDUCATION CALIFORNIA	$7.5B	Education
34	IA DEPARTMENT OF HUMAN SERVICES	$7.5B	Medicaid
35	HUMAN SERVICES, ARKANSAS DEPARTMENT OF	$7.2B	Medicaid
36	ALABAMA MEDICAID AGENCY	$6.6B	Medicaid
37	DEPARTMENT OF TRANSPORTATION CALIFORNIA	$6.3B	Transportation
38	NEVADA DEPARTMENT OF HEALTH & HUMAN SERVICES	$6.1B	Medicaid
39	OFFICE OF EMERGENCY SERVICES	$6.1B	Emergency Services
40	MISSISSIPPI DIVISION OF MEDICAID	$6.0B	Medicaid
41	TEXAS DEPARTMENT OF TRANSPORTATION	$6.0B	Transportation
42	HEALTH AND HUMAN RESOURCES, WEST VIRGINIA DEPARTMENT OF	$4.7B	Medicaid
43	NEW YORK STATE EDUCATION DEPARTMENT	$4.6B	Education
44	KANSAS DEPARTMENT OF HEALTH & ENVIRONMENT	$4.6B	Medicaid
45	STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT	$4.4B	Emergency Services
46	NEW YORK STATE OFFICE OF TEMPORARY & DISABILITY ASSISTANCE	$4.2B	Medicaid
47	HEALTH AND HUMAN SERVICES, MAINE DEPARTMENT OF	$4.0B	Medicaid
48	TX EDUCATION AGENCY	$3.9B	Education
49	NEBRASKA DEPARTMENT OF HEALTH & HUMAN SERVICES	$3.9B	Medicaid
50	PUERTO RICO DEPARTMENT OF HEALTH	$3.7B	Medicaid

Showing 50 of 50 results

Federal Agencies

See where grant money originates

Healthcare Spending

The healthcare machine driving most grants

Spending by State

Total federal dollars flowing to each state

State Dependency

Which states take more than they give