Even if we adjust for inflation, the spending increase in HHS for North Carolina has been growing by huge amounts over the last 35 years. Why do you ask is it growing so much? The quick and easy answer is Medicaid. Most of the state’s welfare programs are administered through HHS, thus resulting in higher expenditures for the agency, the largest of these being Medicaid. As the largest expenditure in the state’s total budget, we will see how much larger it gets before some legislative action is taken to reform HHS.