June 24, 2026
US spending on health care is projected to reach nearly $9 trillion by 2034 according to an analysis by experts at the federal Centers for Medicare and Medicaid Services published online June 24, 2026 in the journal Health Affairs. (Jacqueline A. Fiore, Andrea M. Sisko, John A. Poisal, Sheila D. Smith, Gigi A. Cuckler, Andrew J. Madison, Sean P. Keehan, Kathryn E. Rennie, and Nicholas J. Feehley. National Health Expenditure Projections, 2025–34: Strong Utilization Growth Initially, Legislative Impacts Later. Health Affairs. Published online ahead of print June 24, 2026. doi.org/10.1377/hlthaff.2026.00642.)
According to the authors:
“During 2029–34, national health expenditure growth is projected to average 5.2 percent, reaching nearly $9.0 trillion by 2034 (exhibit 1). Health spending and enrollment trends over the course of 2029–34 are primarily influenced by demographic and economic factors. Because average annual national health spending growth, led by rapid growth in Medicare, is projected to outpace average annual GDP growth during 2029–34 by 1.3 percentage points, the health share of GDP is expected to rise to 20.6 percent by 2034 (exhibits 1 and 2). The insured share of the population is expected to be 90.5 percent in 2034, similar to the share in 2028 (exhibit 3), reflecting enrollment gains in Medicare and Medicaid that are partly offset by a small decline in employer-sponsored insurance.4
“Among the major payers, Medicare spending growth is projected to be the highest during 2029–34, at an average of 7.3 percent per year (exhibit 3). Medicare enrollment growth is expected to average 1.3 percent per year during 2029–34 (compared with 0.8 percent for Medicaid and 0.0 percent for private health insurance). Medicare spending growth per enrollee is expected to average 5.9 percent per year during 2029–34, which reflects utilization trends that, although slower than more recent experience, are assumed to be more consistent with longer-term historical averages (and are also influenced by the impact of the oldest baby boomers reaching ages where health care consumption typically increases). Sequestration, which imposed constraints on certain Medicare payment rates, is scheduled to expire in 2033, which leads to relatively faster annual spending growth in 2033 and 2034.22,23 By 2034, 22 percent of the population is projected to be covered by Medicare (calculable from exhibit 3), and spending attributable to the Medicare program on beneficiaries’ behalf is projected to be 26 percent of national health spending.24“
Specifically regarding Medicare, the authors note:
“Over the course of 2025–34, Medicare is projected to experience the highest spending growth (7.7 percent per year, on average) among the major payers, reflecting faster per enrollee spending growth and faster enrollment growth partially driven by demographic factors (exhibits 3 and 4). The IRA included significant provisions affecting the Medicare Part D benefit: the introduction in 2025 of a $2,000 out-of-pocket cap for Medicare beneficiaries with Part D coverage, indexed annually thereafter; the IRA’s Manufacturer Discount Program; the implementation of Medicare’s Drug Price Negotiation Program, starting in 2026, intended to generate savings for certain high-cost prescription drugs; and the linking of pharmaceutical price increases to the Consumer Price Index (CPI).12 These provisions are generally expected to put downward pressure on out-of-pocket prescription drug spending for beneficiaries and exert upward pressure on Medicare Part D expenditures. The upward pressure on Medicare spending is largely due to the out-of-pocket cap, which transfers expenses from the beneficiary to the Medicare program, as well as the implementation of the negotiations on prescription drug prices in the initial years. Negotiated drugs are projected to reduce manufacturer rebates that formerly came back to the Medicare program but will now be reflected through lower prices at the point of sale.”
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World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems and policies in the US and sixteen other OECD member nations.
Page last updated June 24, 2026 by Doug McVay, Editor.