Insights & Perspectives

The nation’s housing challenges are often framed within the context of cities: Boston’s high and rising rents, San Francisco’s brutal and persistent homelessness, and New York’s cramped and expensive apartments.

In fiscal year 2023, the combination of expiring federal COVID-19 pandemic aid, slowing tax revenue growth, and rising costs for Medicaid led to an increase in the share of state revenue dedicated to Medicaid of 17.8%, or $44.4 billion, over the previous year—the largest single-year rise in at least two decades. States spent 15.1% of every state-generated dollar on Medicaid, up 2.2 percentage points from the previous year, though still about half a cent less than the 15-year average.

Pew Research Center

Philadelphians’ views of their city have improved dramatically since the height of the COVID-19 pandemic in 2022, despite lingering concern about public safety and personal finances. In a Pew survey conducted from January to March 2025, nearly two-thirds of respondents cited crime as the top issue facing the city. Half of those surveyed reported hearing gunshots in their neighborhood in the previous year.

After two consecutive fiscal years of widespread tax revenue declines, states had fewer resources to work with at the start of calendar year 2025 than they had in recent years, which limited their capacity to fund tax cuts, expanded public services, recession preparedness, and other priorities.

Hurricane Helene ravaged the southeastern United States for three days in September 2024, leaving a path of destruction and hundreds of casualties throughout North Carolina and five other states. Record-breaking rainfall devastated western North Carolina and triggered landslides that left many areas cut off from essential services for days. The mountain tourist hub of Asheville faced unprecedented destruction, including widespread property damage and disruptions to critical infrastructure.