Health spending growth in the United States is projected to average 5.8 percent for 2014-24, reflecting the Affordable Care Act's coverage expansions, faster economic growth, and population aging. Recent historically low growth rates in the use of medical goods and services, as well as medical prices, are expected to gradually increase. However, in part because of the impact of continued cost-sharing increases that are anticipated among health plans, the acceleration of these growth rates is expected to be modest. The health share of US gross domestic product is projected to rise from 17.4 percent in 2013 to 19.6 percent in 2024.

The economic recession and rising unemployment-plus changing demographics and baby boomers aging into Medicare-are among the factors expected to influence health spending during 2009-2019. In 2009 the health share of gross domestic product (GDP) is expected to have increased 1.1 percentage points to 17.3 percent-the largest single-year increase since 1960. Average public spending growth rates for hospital, physician and clinical services, and prescription drugs are expected to exceed private spending growth in the first four years of the projections. As a result, public spending is projected to account for more than half of all U.S. health care spending by 2012.

In 2010, US health spending is estimated to have grown at a historic low of 3.9 percent, due in part to the effects of the recently ended recession. In 2014, national health spending growth is expected to reach 8.3 percent when major coverage expansions from the Affordable Care Act of 2010 begin. The expanded Medicaid and private insurance coverage are expected to increase demand for health care significantly, particularly for prescription drugs and physician and clinical services. Robust growth in Medicare enrollment, expanded Medicaid coverage, and premium and cost-sharing subsidies for exchange plans are projected to increase the federal government share of health spending from 27 percent in 2009 to 31 percent by 2020. This article provides perspective on how the nation's health care dollar will be spent over the coming decade as the health sector moves quickly toward its new paradigm of expanded insurance coverage. N ational health spending is expected to grow 5.8 percent per year for the period 2010 through 2020, 1.1 percentage points faster than the expected average annual rise in gross domestic product. As a result, the health share of the gross domestic product is projected to increase from 17.6 percent in 2009 to 19.8 percent by 2020.1 During this period, we expect that the Affordable Care Act of 2010 will reduce the number of uninsured people by nearly thirty million, lead to prescription drugs and physician services accounting for a greater share of health spending than would have been the case otherwise, and contribute to an increase in the government-sponsored (federal, state, and local) share of health spending to just under 50 percent by 2020.In this article we review some highlights of overall projected spending trends in several time periods; summarize our methods and assumptions; then provide an outlook for major health industry sectors, payers, and sponsors. In so doing, we provide perspective on how the nation's health care dollar will be spent over the coming decade as the health sector moves quickly toward its new paradigm of expanded insurance coverage. 2010National health spending is estimated to have reached $2.6 trillion in 2010, reflecting a growth rate of 3.9 percent over the previous year, which is slightly slower than the previous historic low growth rate of 4.0 percent in 2009 (Exhibits 1 and 2).2 Growth in nominal gross domestic product (that is, not adjusted for inflation) accelerated to 3.8 percent in 2010 from −1.7 percent in 2009.3 Because the rate of economic growth has accelerated and the projected rate of growth of health spending is similar, the health share of gross domestic product is projected to remain unchanged in 2010 at 17.6 percent. This is in

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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.