A small percentage of Medicaid-only enrollees—those who were not also eligible for Medicare—consistently accounted for a large percentage of total Medicaid expenditures, according to the Government Accountability Office.

GAO analyzed data from the Medicaid Statistical Information System Annual Person Summary File for fiscal years 2009, 2010, and 2011—the most recent years for which data from almost all states were available. What auditors found was that in fiscal years 2009-2011 the most expensive 5 percent of Medicaid-only enrollees accounted for almost half of the expenditures for all Medicaid-only enrollees. By comparison, the least expensive 50 percent of Medicaid-only enrollees accounted for less than 8 percent of the expenditures for these enrollees.

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