NORTH GREENBUSH, N.Y. — When she turned 100 last year, Gladys Dewitt felt well enough to get up and dance. She enjoyed her birthday cake as people made a fuss around her and a newspaper photographer snapped her picture.

But she couldn't have what she really wanted for her birthday.

"I wanted to go home,'' she recalled recently, lying in her bed in the Van Rensselaer Nursing Home just a few miles from the state Capitol.

But like most of the 360 other residents of the county-run facility, she had no home to go back to. It had been sold long before, when she could no longer take care of herself.

Now, she depends on Medicaid, the taxpayer-supported health-care-insurance program, to pay for her care.

While she is well cared for, she is not happy to be where she is. Nor are taxpayers happy to be footing the bill.

Every day she has been at the nursing home, a little more than two years, Medicaid has paid the home $159.85, or more than $58,345 a year. Last year alone, nursing homes in New York got $7.4 billion in Medicaid funds to care for about 88,000 residents — about 78 percent of all people who live in nursing homes.

Exploding Medicaid costs are a problem everywhere in the country, but the problem is most severe in New York, which spends far more than any other state, about $42 billion — more than California and Texas combined, which together have three times as many people as New York.

"Medicaid is the biggest reason our taxes are the highest in the country," said Robert Ward of the state Business Council.

© 2004, Gannett News Service