RICHMOND, Va. — Not long ago, Virginia was considered to be in the pink of economic health. That diagnosis has turned dark red as the state and its municipalities pile up debt.

On paper, Virginia maintains a balanced budget. But government indebtedness is expanding faster than any single budget category — including the much-debated cost of Medicaid.

Debt-service expenditures jumped 120 percent since 2006, reports Jim Regimbal, principal of Fiscal Analytics Ltd., in Richmond.