Growth in national health spending is projected to slow in 2005 to 7.4 percent, from a peak of 9.1 percent in 2002. Private health insurance premiums are projected to slow to 6.6 percent in 2005, with a rebound expected in 2007. The introduction of Medicare Part D drug coverage in 2006 produces a dramatic shift in spending across payers but has little net effect on aggregate spending growth. Health spending is expected to consistently outpace gross domestic product (GDP) over the coming decade, accounting for 20 percent of GDP by 2015.

National health spending growth is anticipated to remain stable at just over 7.0 percent through 2006, the result of diverging public- and private-sector spending trends. The faster public-sector spending growth is exemplified by the introduction of the new Medicare drug benefit in 2006. While this benefit is anticipated to have only a minor impact on overall health spending, it will result in a significant shift in funding from private payers and Medicaid to Medicare. By 2014, total health spending is projected to constitute 18.7 percent of gross domestic product, from 15.3 percent in 2003.

We present a dynamic general equilibrium model of the U.S. economy and the medical sector in which the adoption of new medical treatments is endogenous and the demand for medical services is conditional on the state of technology. We use this model to prepare 75-year medical spending forecasts and a projection of the Medicare actuarial balance, and we compare our results to those obtained from a method that has been used by government actuaries. Our baseline forecast predicts slower health spending growth in the long run and a lower Medicare actuarial deficit relative to the previous projection methodology.

Background The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental healthy foods and nutrition education to children under age 5 years in low-income households. Objective To identify characteristics associated with duration of WIC participation and assess how participation duration relates to household food insecurity (HFI), child diet quality, and child weight status at age 60 months. Methods This analysis of the WIC Infant and Toddler Feeding Practices Study-2, a prospective cohort of WIC-participating children enrolled in 2013, includes children with complete baseline-60 month data (n, 836). Outcomes assessed with WIC-participation duration in multivariable regression were HFI (US Department of Agriculture 6-item Household Food Security Screener), child diet quality on a given day (Healthy Eating Index (HEI)-2015) and obesity (Centers for Disease Control and Prevention BMI-for-age ≥95th percentile). Results Factors associated with longer WIC participation included male sex, lower household income, reported diet changes in response to WIC nutrition education, household SNAP participation, English-speaking Hispanic, Spanish-speaking Hispanic and Non-Hispanic Other maternal race/ethnicity-language preference, an ever-married mother, lower maternal education, higher maternal age, earlier enrollment during pregnancy, and reporting a subsequent pregnancy. Longer WIC participation was associated with lower HFI odds (OR, 0.69, 95%CI, 0.51-0.95), higher total HEI-2015 (β, 0.73, 95%CI, 0.20-1.25), and higher obesity odds (OR, 1.20, 95%CI, 1.05-1.37) in multivariable adjusted regression models. Conclusions Longer WIC participation was associated with reduced HFI and higher diet quality, and unexpectedly with higher obesity odds at 60 months. Further research is needed to confirm and understand mechanisms underlying unexpected associations identified with longer WIC participation (e.g. male sex, obesity). Groups with shorter participation durations may benefit from targeted WIC retention efforts to maximize nutrition security.

Early in the COVID-19 pandemic, the U.S. Department of Agriculture (USDA), State governments, and school districts took unprecedented steps to mitigate the pandemic’s impact on students’ nutrition. To examine the effect of emergency responses on 6-year-old children’s nutritional outcomes, this study analyzed longitudinal data from a national study of children’s feeding practices, the Special Supplemental Nutrition Program for Women, Infants, and Children—Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2). Findings include no differences in food insecurity prevalence; however, there were shifts in sources of food, with children in the post-COVID-emergency-declaration (post-ED) group consuming more dietary energy from stores and community food programs and less from restaurants and schools than children in the pre-COVID-emergency-declaration (pre-ED) group (p < 0.01 for all comparisons). Examination of within-person mean differences in 2015 Healthy Eating Index scores and nutrient intakes between ages 5 and 6 years revealed few statistically significant differences between the two groups: children in the post-ED group consumed slightly fewer vegetables (p = 0.02) and less sodium (p = 0.01) than their pre-ED peers. Findings suggest emergency efforts to maintain children’s nutrition were largely successful in the early months of the pandemic. Research is needed to understand the mechanisms by which emergency efforts contributed to these findings.