Which US states had the highest total TANF and Medicaid per-capita spending in 2022?

1. What proponents claim and what the records actually show — a mismatch that matters

The question presumes that a clear, published tally exists for combined TANF and Medicaid per‑capita spending by state for 2022, but the material provided shows that no single source in this packet publishes that combined metric directly. The Office of Family Assistance publishes detailed TANF caseload and expenditure tables that are useful for state‑level TANF accounting, yet those datasets typically report TANF dollar totals and program categories rather than a per‑resident “TANF per‑capita” figure ready for addition to Medicaid per‑capita spending ^[3]. Medicaid reporting in the packet includes per‑capita Medicaid expenditure measures and state fact sheets, but those are isolated to Medicaid alone; the sources therefore establish the existence of component data rather than the combined ranking the original question requests ^{[1] [2]}.

2. What Medicaid data tells us — states with relatively high per‑capita commitments

The Medicaid materials in the packet report state variation in Medicaid per‑capita expenditures and show a nationwide median and range that provide context for which states likely contribute the largest share of the combined total. One source emphasizes a median Medicaid per‑capita spending of $9,108 and documents considerable interstate variation in Medicaid outlays; this identifies Medicaid as the dominant driver of any combined welfare per‑capita number because Medicaid spending dwarfs TANF in scale in most states ^[1]. State fact sheets reinforce that Medicaid enrollment, eligibility rules, and program cost drivers differ significantly across states, meaning states with high Medicaid per‑capita spending will likely appear at the top of any combined list unless their TANF per‑capita spending is unusually low ^[2].

3. What TANF sources offer — detailed but narrow program accounting

TANF reporting from the Office of Family Assistance and related analyses offers state breakdowns of TANF expenditures, caseloads, and program composition, but the packet’s TANF materials do not present a standardized TANF per‑capita spending figure formatted for direct summation with Medicaid per‑capita amounts. TANF totals are often reported as program dollar amounts or as shares by category (e.g., basic assistance, work supports), and some analyses note that states allocate less than one‑fourth of TANF dollars to basic cash assistance, signaling wide policy variation in how TANF funds are used ^{[4] [3]}. To create a combined per‑capita ranking, one would need to convert state TANF dollar totals into a per‑resident basis and add those to Medicaid per‑capita figures; the packet lacks that conversion for 2022 specifically ^[3].

4. Cross‑source synthesis — what can be inferred and what remains speculative

Using the packet’s Medicaid per‑capita measures together with state TANF totals would allow an approximate ranking, but the sources in hand stop short of supplying a prepared combined list for 2022. Urban‑style public welfare expenditure reports within the packet show states like New York rank high on public‑welfare per‑capita measures, hinting that states with large social spending footprints likely top a combined TANF+Medicaid metric, yet those public‑welfare measures include programs beyond TANF and Medicaid and therefore are not a direct substitute ^[5]. The prudent conclusion from these materials is that Medicaid dominates the combined total, so states with unusually high Medicaid per‑capita spending will almost certainly lead any combined ranking, but final ordering requires a precise TANF per‑resident conversion not present here ^{[1] [5]}.

5. What would be needed to produce the exact 2022 list — a short methodological roadmap

To produce an authoritative state ranking of combined TANF plus Medicaid per‑capita spending for 2022, one must obtain state‑level Medicaid per‑capita expenditures (already present in the packet) and state TANF total expenditures for 2022, convert TANF totals into a per‑resident basis using 2022 state population counts, and then sum the two per‑capita figures. The Office of Family Assistance TANF tables supply the necessary TANF totals, but an explicit per‑resident conversion and a consistent per‑capita Medicaid dataset matched year and population are required to finalize the list; neither step is completed in the supplied documents ^{[3] [4] [2]}. Once those calculations are executed, the combined ranking would be reproducible and comparable across states.

6. Bottom line for decision‑makers and researchers — do the sources suffice?

The packet provides the component data and context needed to construct a combined 2022 TANF+Medicaid per‑capita ranking, but it does not present a ready‑made list; Medicaid per‑capita numbers are available and TANF totals are published, yet the necessary state‑level arithmetic to merge them into a 2022 per‑capita ordering has not been performed within these sources. Analysts seeking the exact state order should extract 2022 state TANF expenditure totals from the Office of Family Assistance tables, secure consistent 2022 Medicaid per‑capita figures, apply 2022 population denominators, and then add the two per‑capita numbers to produce a definitive, reproducible ranking ^{[3] [1] [4]}.