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While its benefits are clear and widely supported, Medicaid’s costs are far more controversial. In New York, total spending for Medicaid of $36 billion in fiscal year 2003 represented nearly 40 percent of total State expenditures. The portion of the Medicaid program paid for with State-raised revenues (as distinct from federal aid and local government contributions) totaled $12.6 billion or more than one-quarter of all State spending financed with State revenues.