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This paper profiles cost changes in Missouri's Medicaid program between 2001 and 2005. Missouris Medicaid expenditures increased by almost 50 percent (from $4.2 billion to $6.3 billion), predominately due to increases in enrollment, as well as changes in case mix. This report analyzes the growth in Medicaid spending using data provided by the Missouri Department of Social Services on expenditure by eligibility group and service category.