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World Health Systems Facts

Medicare: Expenditures

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“Total Medicare expenditures were $839 billion in 2021. The Board estimates that the COVID-19 pandemic has had significant effects on the short-term financing and spending of the Medicare program, but the financial status of the trust funds has not materially changed. The Trustees project that expenditures will increase in future years at a faster pace than either aggregate workers’ earnings or the economy overall and that, as a percentage of GDP, spending will increase from 3.9 percent in 2021 to 6.5 percent by 2096 (based on the Trustees’ intermediate set of assumptions). Under the relatively higher price increases for physicians and other health services assumed for the illustrative alternative projection, Medicare spending would represent roughly 8.6 percent of GDP in 2096. Growth under either of these scenarios would substantially increase the strain on the nation’s workers, the economy, Medicare beneficiaries, and the Federal budget.”

Source: The Boards of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, 2022 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplemental Medical Insurance Trust Funds, June 2, 2022.


“In 2021, Medicare covered 63.8 million people: 55.5 million aged 65 and older, and 8.3 million disabled. About 43 percent of these beneficiaries have chosen to enroll in Part C private health plans that contract with Medicare to provide Part A and Part B health services. Total expenditures in 2021 were $839.3 billion, and total income was $887.6 billion, which consisted of $882.3 billion in non-interest income and $5.3 billion in interest earnings. Assets held in special issue U.S. Treasury securities increased by $48.3 billion to $325.7 billion. The significant increase in assets was due to lower actual expenditures than estimated in last year’s report.”

Source: The Boards of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, 2022 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplemental Medical Insurance Trust Funds, June 2, 2022.


“In 2019, HI [Hospital Insurance Trust Fund] expenditures exceeded income by $5.8 billion. The Trustees project deficits in all future years until the trust fund becomes depleted in 2026. The assets were $194.6 billion at the beginning of 2020, representing about 55 percent of expenditures projected for 2020, which is below the Trustees’ minimum recommended level of 100 percent. The HI trust fund has not met the Trustees’ formal test of short-range financial adequacy since 2003. Growth in HI expenditures has averaged 4.0 percent annually over the last 5 years, compared with non-interest income growth of 4.7 percent. Over the next 5 years, projected average annual growth rates for expenditures and noninterest income are 6.5 percent and 5.2 percent, respectively.

“The SMI [Supplementary Medical Insurance] trust fund is expected to be adequately financed over the next 10 years and beyond because income from premiums and general revenue for Parts B and D are reset each year to cover expected costs and ensure a reserve for Part B contingencies. The monthly Part B premium for 2020 is $144.60.

“Part B and Part D costs have averaged annual growth rates of 6.9 percent and 4.5 percent, respectively, over the last 5 years, as compared to growth of 4.1 percent for GDP. The Trustees project that cost growth over the next 5 years will average 8.2 percent for Part B and 7.3 percent for Part D, significantly faster than the projected average annual GDP growth rate of 4.3 percent over the period.”

Source: The Boards of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, 2020 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplemental Medical Insurance Trust Funds, April 22, 2020.


Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.


Page last updated Jan. 27, 2023 by Doug McVay, Editor.

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