<P> 1996: Passed under Clinton, the "Personal Responsibility and Work Opportunity Reconciliation Act of 1996" becomes law . </P> <P> 2013: Affordable Care Act goes into effect with large increases in Medicaid and subsidized medical insurance premiums go into effect . </P> <Table> <Tr> <Th_colspan="4"> (hide) 79 Means Tested Programs in U.S. (2011) </Th> </Tr> <Tr> <Th> Programs </Th> <Th> Federal Spending </Th> <Th> State Spending </Th> <Th> Total Spending </Th> </Tr> <Tr> <Td> TOTAL cost in (billions) (2011) </Td> <Td> $717 </Td> <Td> $210 </Td> <Td> $927 </Td> </Tr> <Tr> <Td> Social Security OASDI (2013) </Td> <Td> </Td> <Td> </Td> <Td> $785 </Td> </Tr> <Tr> <Td> Medicare (2013) </Td> <Td> </Td> <Td> </Td> <Td> $574 </Td> </Tr> <Tr> <Th> TOTAL all programs (billions) </Th> <Td> </Td> <Td> </Td> <Td> $2,286 </Td> </Tr> <Tr> <Th_colspan="4"> CASH ASSISTANCE (millions) </Th> </Tr> <Tr> <Td> SSI / Old Age Assistance </Td> <Td> 56,462.00 </Td> <Td> 4,673.00 </Td> <Td> 61,135.00 </Td> </Tr> <Tr> <Td> Earned Income Tax Credit (refundable portion) </Td> <Td> 55,652.00 </Td> <Td> </Td> <Td> 55,652.00 </Td> </Tr> <Tr> <Td> Refundable Child Credit </Td> <Td> 22,691.00 </Td> <Td> </Td> <Td> 22,691.00 </Td> </Tr> <Tr> <Td> Make Work Pay Tax Credit (Refundable Portion) </Td> <Td> 13,905.00 </Td> <Td> </Td> <Td> 13,905.00 </Td> </Tr> <Tr> <Td> Temporary Assistance for Needy Families (TANF, old AFDC) </Td> <Td> 6,882.89 </Td> <Td> 6,876.86 </Td> <Td> 13,759.74 </Td> </Tr> <Tr> <Td> Foster Care Title IVE </Td> <Td> 4,456.00 </Td> <Td> 3,921.28 </Td> <Td> 8,377.28 </Td> </Tr> <Tr> <Td> Adoption Assistance Title IVE </Td> <Td> 2,362.00 </Td> <Td> 1,316 </Td> <Td> 3,678.00 </Td> </Tr> <Tr> <Td> General Assistance Cash </Td> <Td> </Td> <Td> 2,625.00 </Td> <Td> 2,625.00 </Td> </Tr> <Tr> <Td> Refugee Assistance </Td> <Td> 167.86 </Td> <Td> </Td> <Td> 167.86 </Td> </Tr> <Tr> <Td> General Assistance to Indians </Td> <Td> 115.00 </Td> <Td> </Td> <Td> 115.00 </Td> </Tr> <Tr> <Td> Assets for Independence </Td> <Td> 24.00 </Td> <Td> </Td> <Td> 24.00 </Td> </Tr> <Tr> <Th> CASH TOTAL </Th> <Td> 162,717.75 </Td> <Td> 19,412.14 </Td> <Td> 182,129.88 </Td> </Tr> <Tr> <Th_colspan="4"> MEDICAL </Th> </Tr> <Tr> <Td> Medicaid </Td> <Td> 274,964.00 </Td> <Td> 157,600.00 </Td> <Td> 432,564.00 </Td> </Tr> <Tr> <Td> SCHIP State Supplemental Health Insurance Program </Td> <Td> 8,629.00 </Td> <Td> 3,796.76 </Td> <Td> 12,425.76 </Td> </Tr> <Tr> <Td> Medical General Assistance </Td> <Td> </Td> <Td> 6,965.90 </Td> <Td> 6,965.90 </Td> </Tr> <Tr> <Td> Consolidated Health Center / Community Health Centers </Td> <Td> 1,481.00 </Td> <Td> </Td> <Td> 1,481.00 </Td> </Tr> <Tr> <Td> Maternal & Child Health </Td> <Td> 656.00 </Td> <Td> 492.00 </Td> <Td> 1,148.00 </Td> </Tr> <Tr> <Td> Medical Assistance to Refugees </Td> <Td> 167.86 </Td> <Td> </Td> <Td> 167.86 </Td> </Tr> <Tr> <Td> Healthy Start </Td> <Td> 104.00 </Td> <Td> </Td> <Td> 104.00 </Td> </Tr> <Tr> <Th> MEDICAL TOTAL </Th> <Td> 289,816.86 </Td> <Td> 168,854.66 </Td> <Td> 458,671.52 </Td> </Tr> <Tr> <Th_colspan="4"> FOOD </Th> </Tr> <Tr> <Td> Food Stamps, SNAP </Td> <Td> 77,637.00 </Td> <Td> 6,987.33 </Td> <Td> 84,624.33 </Td> </Tr> <Tr> <Td> School Lunch Program </Td> <Td> 10,321.00 </Td> <Td> </Td> <Td> 10,321.00 </Td> </Tr> <Tr> <Td> WIC Women, Infant and Children Food Program </Td> <Td> 6,787.00 </Td> <Td> </Td> <Td> 6,787.00 </Td> </Tr> <Tr> <Td> School Breakfast </Td> <Td> 3,076.00 </Td> <Td> </Td> <Td> 3,076.00 </Td> </Tr> <Tr> <Td> Child Care Food Program </Td> <Td> 2,732.00 </Td> <Td> </Td> <Td> 2,732.00 </Td> </Tr> <Tr> <Td> Nutrition Program for the Elderly, Nutrition Service Incentives </Td> <Td> 820.00 </Td> <Td> 139.40 </Td> <Td> 959.40 </Td> </Tr> <Tr> <Td> Summer Program </Td> <Td> 376.00 </Td> <Td> </Td> <Td> 376.00 </Td> </Tr> <Tr> <Td> Commodity Supplemental Food Program </Td> <Td> 196.00 </Td> <Td> </Td> <Td> 196.00 </Td> </Tr> <Tr> <Td> TEFAP Temporary Emergency Food Program </Td> <Td> 247.00 </Td> <Td> </Td> <Td> 247.00 </Td> </Tr> <Tr> <Td> Needy Families </Td> <Td> 60.00 </Td> <Td> </Td> <Td> 60.00 </Td> </Tr> <Tr> <Td> Farmers' Market Nutrition Program </Td> <Td> 23.00 </Td> <Td> </Td> <Td> 23.00 </Td> </Tr> <Tr> <Td> Special Milk Program </Td> <Td> 13.00 </Td> <Td> </Td> <Td> 13.00 </Td> </Tr> <Tr> <Th> FOOD TOTAL </Th> <Td> 102,288.00 </Td> <Td> 7,126.73 </Td> <Td> 109,414.73 </Td> </Tr> <Tr> <Th_colspan="4"> HOUSING </Th> </Tr> <Tr> <Td> Section 8 Housing (HUD) </Td> <Td> 28,435.00 </Td> <Td> </Td> <Td> 28,435.00 </Td> </Tr> <Tr> <Td> Public Housing (HUD) </Td> <Td> 8,973.00 </Td> <Td> </Td> <Td> 8,973.00 </Td> </Tr> <Tr> <Td> Low Income Housing Tax Credit for Developers </Td> <Td> 6,150.00 </Td> <Td> </Td> <Td> 6,150.00 </Td> </Tr> <Tr> <Td> Home Investment Partnership Program (HUD) </Td> <Td> 2,853.00 </Td> <Td> </Td> <Td> 2,853.00 </Td> </Tr> <Tr> <Td> Homeless Assistance Grants (HUD) </Td> <Td> 2,280.00 </Td> <Td> </Td> <Td> 2,280.00 </Td> </Tr> <Tr> <Td> State Housing Expenditures (from SWE) </Td> <Td> </Td> <Td> 2,085.00 </Td> <Td> 2,085.00 </Td> </Tr> <Tr> <Td> Rural Housing Insurance Fund (Agriculture) </Td> <Td> 1,689.00 </Td> <Td> </Td> <Td> 1,689.00 </Td> </Tr> <Tr> <Td> Rural Housing Service (Agriculture) </Td> <Td> 1,085.00 </Td> <Td> </Td> <Td> 1,085.00 </Td> </Tr> <Tr> <Td> Housing for the Elderly (HUD) </Td> <Td> 934.00 </Td> <Td> </Td> <Td> 934.00 </Td> </Tr> <Tr> <Td> Native American Housing Block Grants (HUD) </Td> <Td> 854.00 </Td> <Td> </Td> <Td> 854.00 </Td> </Tr> <Tr> <Td> Other Assisted Housing Programs (HUD) </Td> <Td> 496.00 </Td> <Td> </Td> <Td> 496.00 </Td> </Tr> <Tr> <Td> Housing for Persons with Disabilities (HUD) </Td> <Td> 309.00 </Td> <Td> </Td> <Td> 309.00 </Td> </Tr> <Tr> <Th> HOUSING TOTAL </Th> <Td> 54,058.00 </Td> <Td> 2,085.00 </Td> <Td> 56,143.00 </Td> </Tr> <Tr> <Th_colspan="4"> ENERGY AND UTILITIES </Th> </Tr> <Tr> <Td> LIHEAP Low Income Home Energy Assistance </Td> <Td> 4,419.00 </Td> <Td> </Td> <Td> 4,419.00 </Td> </Tr> <Tr> <Td> Universal Service Fund Subsidized Low Income Phone Service </Td> <Td> 1,750.00 </Td> <Td> </Td> <Td> 1,750.00 </Td> </Tr> <Tr> <Td> Weatherization </Td> <Td> 234.00 </Td> <Td> </Td> <Td> 234.00 </Td> </Tr> <Tr> <Th> ENERGY AND UTILITIES TOTAL </Th> <Td> PM 6,403.00 </Td> <Td> </Td> <Td> 6,403.00 </Td> </Tr> <Tr> <Th_colspan="4"> EDUCATION </Th> </Tr> <Tr> <Td> Pell Grants </Td> <Td> 41,458.00 </Td> <Td> </Td> <Td> 41,458.00 </Td> </Tr> <Tr> <Td> Title One Grants to Local Education Authorities </Td> <Td> 14,472.00 </Td> <Td> </Td> <Td> 14,472.00 </Td> </Tr> <Tr> <Td> 21st Century Learning Centers </Td> <Td> 1,157.00 </Td> <Td> </Td> <Td> 1,157.00 </Td> </Tr> <Tr> <Td> Special Programs for Disadvantaged (TRIO) </Td> <Td> 883.00 </Td> <Td> </Td> <Td> 883.00 </Td> </Tr> <Tr> <Td> Supplemental Education Opportunity Grants </Td> <Td> 740.00 </Td> <Td> </Td> <Td> 740.00 </Td> </Tr> <Tr> <Td> Adult Basic Education Grants </Td> <Td> 607.00 </Td> <Td> </Td> <Td> 607.00 </Td> </Tr> <Tr> <Td> Migrant Education </Td> <Td> 444.00 </Td> <Td> </Td> <Td> 444.00 </Td> </Tr> <Tr> <Td> Gear - Up </Td> <Td> 303.00 </Td> <Td> </Td> <Td> 303.00 </Td> </Tr> <Tr> <Td> LEAP Formerly State Student Incentive Grant Program (SSIG) </Td> <Td> 1.00 </Td> <Td> </Td> <Td> 1.00 </Td> </Tr> <Tr> <Td> Education for Homeless Children and Youth </Td> <Td> 65.00 </Td> <Td> </Td> <Td> 65.00 </Td> </Tr> <Tr> <Td> Even Start </Td> <Td> 4.00 </Td> <Td> </Td> <Td> 4.00 </Td> </Tr> <Tr> <Td> Aid for Graduate and Professional Study for Disadvantaged and Minorities </Td> <Td> 41.00 </Td> <Td> </Td> <Td> 41.00 </Td> </Tr> <Tr> <Th> EDUCATION TOTAL </Th> <Td> 60,175.00 </Td> <Td> </Td> <Td> 60,175.00 </Td> </Tr> <Tr> <Th_colspan="4"> TRAINING </Th> </Tr> <Tr> <Td> TANF Work Activities and Training </Td> <Td> 2,504.90 </Td> <Td> 831.93 </Td> <Td> 3,336.83 </Td> </Tr> <Tr> <Td> Job Corps </Td> <Td> 1,659.00 </Td> <Td> </Td> <Td> 1,659.00 </Td> </Tr> <Tr> <Td> WIA Youth Opportunity Grants Formerly Summer Youth Employment </Td> <Td> 946.00 </Td> <Td> </Td> <Td> 946.00 </Td> </Tr> <Tr> <Td> Senior Community Service Employment </Td> <Td> 705.00 </Td> <Td> 77.55 </Td> <Td> 782.55 </Td> </Tr> <Tr> <Td> WIA Adult Employment and Training Formerly JTPA IIA Training for Disadvantaged Adults & Youth </Td> <Td> 766.00 </Td> <Td> </Td> <Td> 766.00 </Td> </Tr> <Tr> <Td> Food Stamp Employment and Training Program </Td> <Td> 393.00 </Td> <Td> 166.00 </Td> <Td> 559.00 </Td> </Tr> <Tr> <Td> Foster Grandparents </Td> <Td> 104.00 </Td> <Td> 10.40 </Td> <Td> 114.40 </Td> </Tr> <Tr> <Td> YouthBuild </Td> <Td> 110.00 </Td> <Td> </Td> <Td> 110.00 </Td> </Tr> <Tr> <Td> Migrant Training </Td> <Td> 85.00 </Td> <Td> </Td> <Td> 85.00 </Td> </Tr> <Tr> <Td> Native American Training </Td> <Td> 52.00 </Td> <Td> </Td> <Td> 52.00 </Td> </Tr> <Tr> <Th> TRAINING TOTAL </Th> <Td> 7,324.90 </Td> <Td> 1,085.88 </Td> <Td> 8,410.78 </Td> </Tr> <Tr> <Th_colspan="4"> SERVICES </Th> </Tr> <Tr> <Td> TANF Block Grant Services </Td> <Td> 5,385.12 </Td> <Td> 4,838.13 </Td> <Td> 10,223.25 </Td> </Tr> <Tr> <Td> Title XX Social Services Block Grant </Td> <Td> 1,787.00 </Td> <Td> </Td> <Td> 1,787.00 </Td> </Tr> <Tr> <Td> Community Service Block Grant </Td> <Td> 678.00 </Td> <Td> </Td> <Td> 678.00 </Td> </Tr> <Tr> <Td> Social Services for Refugees Asylees and Humanitarian Cases </Td> <Td> 417.28 </Td> <Td> </Td> <Td> 417.28 </Td> </Tr> <Tr> <Td> Safe and Stable Families </Td> <Td> 553.00 </Td> <Td> </Td> <Td> 553.00 </Td> </Tr> <Tr> <Td> Title III Aging Americans Act </Td> <Td> 369.00 </Td> <Td> </Td> <Td> 369.00 </Td> </Tr> <Tr> <Td> Legal Services Block Grant </Td> <Td> 406.00 </Td> <Td> </Td> <Td> 406.00 </Td> </Tr> <Tr> <Td> Family Planning </Td> <Td> 298.00 </Td> <Td> </Td> <Td> 298.00 </Td> </Tr> <Tr> <Td> Emergency Food and Shelter Program </Td> <Td> 48.00 </Td> <Td> </Td> <Td> 48.00 </Td> </Tr> <Tr> <Td> Healthy Marriage and Responsible Fatherhood Grants </Td> <Td> 50.00 </Td> <Td> </Td> <Td> 150.00 </Td> </Tr> <Tr> <Td> Independent Living (Chafee Foster Care Independence Program) </Td> <Td> 140.00 </Td> <Td> 28.00 </Td> <Td> 168.00 </Td> </Tr> <Tr> <Td> Independent Living Training Vouchers </Td> <Td> 45.00 </Td> <Td> </Td> <Td> 45.00 </Td> </Tr> <Tr> <Td> Maternal, Infants and Children Home Visitation </Td> <Td> 36.00 </Td> <Td> </Td> <Td> 36.00 </Td> </Tr> <Tr> <Th> SERVICES TOTAL </Th> <Td> 10,411.40 </Td> <Td> 4,866.13 </Td> <Td> 15,277.53 </Td> </Tr> <Tr> <Th_colspan="4"> CHILD CARE AND CHILD DEVELOPMENT </Th> </Tr> <Tr> <Td> Headstart </Td> <Td> 7,559.0 </Td> <Td> 1,889.75 </Td> <Td> 9,448.75 </Td> </Tr> <Tr> <Td> Childcare and Child Development Block Grant </Td> <Td> 2,984 </Td> <Td> 2,176.00 </Td> <Td> 5,160.00 </Td> </Tr> <Tr> <Td> Childcare Entitlement to the States </Td> <Td> 3,100.00 </Td> <Td> </Td> <Td> 3,100.00 </Td> </Tr> <Tr> <Td> TANF Block Grant Child Care </Td> <Td> 2,318.56 </Td> <Td> 2,643.78 </Td> <Td> 4,962.35 </Td> </Tr> <Tr> <Th> CHILD CARE & CHILD DEVELOPMENT TOTAL </Th> <Td> 15,961.56 </Td> <Td> 6,709.53 </Td> <Td> 22,671.10 </Td> </Tr> <Tr> <Th_colspan="4"> COMMUNITY DEVELOPMENT </Th> </Tr> <Tr> <Td> Community Development Block Grant and Related Development Funds </Td> <Td> 7,445.00 </Td> <Td> </Td> <Td> 7,445.00 </Td> </Tr> <Tr> <Td> Economic Development Administration (Dept. of Commerce) </Td> <Td> 423.00 </Td> <Td> </Td> <Td> 423.00 </Td> </Tr> <Tr> <Td> Appalachian Regional Development </Td> <Td> 68.00 </Td> <Td> </Td> <Td> 68.00 </Td> </Tr> <Tr> <Td> Empowerment Zones, Enterprise Communities Renewal </Td> <Td> 1.00 </Td> <Td> </Td> <Td> 1.00 </Td> </Tr> <Tr> <Th> COMMUNITY DEVELOPMENT TOTAL </Th> <Td> 7,937.00 </Td> <Td> </Td> <Td> 7,937.00 </Td> </Tr> <Tr> <Th> TOTAL in millions (2011) </Th> <Td> $717,093.48 </Td> <Td> $210,140.07 </Td> <Td> $927,233.55 </Td> </Tr> <Tr> <Td> Social Security OASDI (2013) </Td> <Td> </Td> <Td> </Td> <Td> $785,700 </Td> </Tr> <Tr> <Td> Medicare (2013) </Td> <Td> </Td> <Td> </Td> <Td> $574,200 </Td> </Tr> <Tr> <Th> TOTAL in millions </Th> <Td> </Td> <Td> </Td> <Td> $2,287,133 </Td> </Tr> </Table> <Tr> <Th_colspan="4"> (hide) 79 Means Tested Programs in U.S. (2011) </Th> </Tr>

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