CROWDING-OUT: Growth in State Medicaid Spending Crowding Out Spending on Other Major State Programs. It’s funny, but state universities are being pinched by other spending priorities. A half-century ago, most states spent money on roads, law enforcement, public health, and education. Now they spend money on lots of other things, each with its own constituency. Most of those constituencies are more influential than university faculty. This was entirely predictable, and yet. . . .