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The welfare state is now omnipresent in every part of the United States. The federal budget is dominated by entitlement spending, with 45 percent of federal spending in 2012 going to Social Security, Medicaid, and Medicare (among other health care entitlements).
Simultaneously, states are struggling under the fiscal burdens imposed on them by mandatory entitlement programs: for example, spending by the S.C. Department of Health and Human Services (primarily on Medicaid) has averaged $1.21 billion over the last three budget years.
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