About 31% of state Medicaid spending in 2009 was for services needed by 4.3% of Medicaid-only beneficiaries. That year, there were 64.4 million Medicaid enrollees. Total state and federal Medicaid expenditures were $314.3 billion, and $203.3 billion (64.7%), was spent on the needs of Medicaid-only beneficiaries. The high cost beneficiaries were those with total per-person costs among the highest five percent of expenditures in each state. The average per capita spending among the high-expenditure Medicaid-only group was $35,983; across the states the per capita expenditure for this group ranged . . .