State & Local The Pew Charitable Trusts · May 28, 2026 · All 50 states
Federal funds remain about a third of state budgets — with Medicaid nearly 70% of federal grants to states (external link to The Pew Charitable Trusts)
Pew's fiscal analysis finds federal dollars accounted for 34.2% of total state revenue in fiscal 2024 — the third consecutive annual decline from the fiscal 2021 record of 36.7% as pandemic aid phased out — while total federal grants to states still topped $1 trillion for the third straight year. Medicaid alone was 68.8% of federal grants to states; assistance programs such as TANF and school nutrition were the second-largest category at 11.3%.
Why it matters
Most "state" human services funding is substantially federal money passing through state budgets. That means federal policy changes reach local programs through state fiscal decisions — and states' dependence on federal funds is the mechanism by which Medicaid changes, in particular, become human services budget pressure. Understanding this chain helps organizations read their own state budget news.
Independent public policy research organization · Topics: state budgets, federal grants, Medicaid, pass-through funding · Checked August 19, 2026 · Read the original at The Pew Charitable Trusts (external link)