By skyforbes 
Health care benefits for public employees and retirees, not Medicaid, account for a majority of the growth in state and local health care spending. Adjusted for inflation, spending for those health care benefits rose 447 percent between 1987 and 2013. Medicaid spending rose a great deal as well, but not as much, 386 percent.
That’s because a large proportion of Medicaid costs is paid by the federal government, including 100 percent of the costs of the Medicaid expansion through 2016, trending down to 90 percent by 2020 and holding at that level thereafter.
Medicaid is by no means a perfect system for delivering health care, but it is the cheapest source of coverage.
(1) It costs about $3,200 per year to cover an adult on Medicaid, again with the federal government picking up most of the tab.
(2) Private insurance, delivered through an employer, costs about $5,300 annually.
“The main source of the problem is growing spending on health care for state employees. Health care spending for retired state employees and their beneficiaries grew 61 percent in the past six years.”
The Pew Charitable Trusts predicts that over the next 40 years spending on health care alone will surpass that for all other state and local government services. Coverage for “public-sector retirees”accounts for much of state and local health care spending, even though Medicare pays most of the costs once those retirees reach 65.