North Carolina is breaking the Medicaid budget lawmakers approved this summer because more people need health insurance coverage after losing their jobs and are getting treated for swine flu, an agency official told the Associated Press. State spending for the government health insurance program for low-income families, senior citizens, and the disabled is $160 million over budget so far this fiscal year as expenditures have surged nearly 9% compared to a year ago, Health and Human Services Secretary Lanier Cansler said.