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This report is the fourth in a series responding to a mandate under the American Recovery and Reinvestment Act of 2009 (Recovery Act). As of November 27, 2009, $69.1 billion, or about one quarter of the approximately $280 billion of total Recovery Act funds for programs administered by states and localities, had been paid out. The largest programs were the Medicaid Federal Medical Assistance Percentage (FMAP), the State Fiscal Stabilization Fund (SFSF), and highways. The Government Accountability Office's (GAO) work continues to focus on 16 states and the District of Columbia (District).

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