“PHI [Private Health Insurance] spending was to $1,183.9 billion in 2017. Through employer contributions to employer sponsored health insurance premiums, private businesses financed 45.3 percent ($536.3 billion) of PHI spending – the largest contribution among sponsors. Households were the second largest sponsor of PHI spending, financing 31.5 percent ($372.4 billion) of PHI spending through employee contributions to employer-sponsored health insurance premiums (23.5 percent), household contributions to direct purchase insurance (4.6 percent) and the medical portion of property and casualty insurance (3.4 percent). The government had the smallest contribution to PHI spending with state and local governments financing 16.2 percent ($192.3 billion) and federal government financing 7.0 percent ($83.0 billion) of PHI spending through contributions to health insurance premiums in their roles as employers and, in the case of the federal government, marketplace tax credits and subsidies as well.

“Medicare spending was to $705.9 billion in 2017. As has been the case since 2005, the federal government was the largest sponsor of Medicare spending in 2017. The federal government financed 46.0 percent ($324.7 billion) of Medicare spending, mainly through federal general revenue and Medicare net trust fund expenditures. This comes from funds appropriated by Congress to finance Medicare, reflecting Medicare spending that is not “self-financed” by households via payroll taxes and beneficiary premiums. Through those two avenues, households financed 34.1 percent ($240.1 billion) of Medicare spending in 2017. Prior to 2005, households were the largest sponsor of Medicare spending but this has changed through a series of expansionary policies that have required increasing shares of federal government financing. Fifteen percent ($107.5 billion) of Medicare spending was sponsored by private businesses in the form of Medicare hospital insurance trust fund payroll taxes and 4.7 percent ($32.9 billion) by state and local governments through various channels, the largest of which was the payroll taxes for state and local government employees.”

Source: Apoorva Rama, National Health Expenditures, 2017: The slowdown in spending growth continues, AMA Policy Research Perspectives, American Medical Association, 2019. https://www.ama-assn.org/about/research/trends-health-care-spending