In fiscal year 2011, the federal government provided $607 billion in grants to state and local governments. Those funds accounted for 17 percent of federal outlays, 4 percent of gross domestic product (GDP), and a quarter of spending by state and local governments that year. Over the past 30 years, those “intergovernmental” grants—financial transfers from the federal government that support a wide range of state and local programs—have fluctuated as a share of federal outlays (see figure below). Federal grants for health programs, primarily Medicaid, have grown rapidly, and grants for programs and initiatives not related to health—such as those associated with income security, education, and transportation—have also increased, albeit at a slower rate. In total, the federal government reported outlays in 2011 for more than 200 intergovernmental grant programs, which were administered by 30 federal departments and independent agencies.