National Health Costs for 2021 reached an estimated level of $12,914 per capita (per person). Which means every man, woman and child spent on average, over $35 EACH DAY (either through insurance, out-of-pocket costs or taxes) to pay for America’s healthcare. This represented 18.3 percent of GDP, $4.3 trillion. Total health spending increased 2.7% in 2021. However, the percent of GDP devoted to health declined by 1.4 points from 2020. This is due to the overall economy growing 10.7% during the year, resulting in healthcare taking up a smaller proportion. Federal government spending on healthcare went down 3.5%, compared to nearly 37% growth during the first year of the pandemic. Federal COVID-19 supplemental funding went down almost 63% from 2020.
Medicare spending grew 8.4%,compared to 3.6% in 2020. Medicaid growth was 9.2%, similar to 9.3% in 2020. Private insurance increased by 5.8%, partly due to higher enrollment. Out of pocket increased by 10.4% as people returned to using services during 2021. Dental spending rose 16.1% in 2021. Retail prescription drug spending was up another 7.8%. Nursing home and retirement community spending declined by 7.9%. CMS data published December 2022.
Health Insurance Coverage in the United States: 2021 provides information and statistics about the uninsured and people with insurance. Information was collected in the Current Population Survey (CPS) and the American Community Survey (ACS). Overall, the uninsured rate was estimated at 8.3%. For working-age adults, the uninsured rate was 11.6%. For those who were not citizens, about 1/3 were uninsured. Check the 2019 report to see rates of uninsured by state (the highest rates were in Texas, Oklahoma, Georgia, Florida and Mississippi.) The 2018 report goes further to show the percent uninsured mapped by Congressional district. US Census Bureau (census.gov) report was issued September 2022.
The Medicare hospital insurance fund (Part A) runs out of money in 2031, according to the latest report from the Medicare Trustees. The March 2023 report by CMS discusses the state of each of the Medicare Trust funds – a $905 billion program for 65 million people in 2022. Medicare expenditures alone are estimated at 3.7% of gross domestic product (2022), down 0.1 point since last year. Part B (outpatient) and Part D (drug) have “adequate financing” – i.e., they are in decent shape. However, the hospital trust fund is projected to be depleted by 2031 (three years later than projected last year). This is the 6th consecutive year of a Medicare funding warning. Both the President and Congress have responsibilities to address the warning by working on legislation. The financial situation was improved over 2021, as utilization did not rebound from the 2021 pandemic year as much as expected. In addition, a faster-than-expected economic recovery brought in more payroll taxes to help fund Medicare. The Medicare Board of Trustees projects a surplus of income over expense for 2023 and 2024, then annual deficits eat into Medicare’s reserves. By 2031, the hospital fund gets depleted – just eight years away. In 2022, the average total Medicare benefit per enrollee was $14,908.
Survey from National Federation of Independent Business (NFIB Research Foundation) identified cost of health insurance as the number one concern of small businesses in 2020. The survey has reportedly shown cost of health insurance to be the number 1 concern for 29 years. The report cites health insurance costs for small firms as having risen 43 percent in the last decade. Data are from a February to mid-March (pre-pandemic) mail survey; 2552 respondents (13% response rate). Most respondents have fewer than 10 employees. Published August 2020.
Archived for the record of the Affordable Care Act during Mr. Obama’s presidency. During Obama’s tenure, the percent uninsured was reduced by about 44%. Although health reform plans called for a slowing in the rate of GROWTH of annual healthcare spending. it contrasted with the bold campaign promise of actually lowering spending. A 2008 Campaign quote: “Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year. If you don’t have health insurance, you will have a choice of new, affordable health insurance options.” Those who experienced cost reductions likely were getting income-related federal subsidies.
On average, 2023 individual premiums were just over $600 per month for a plan on last year’s health insurance exchanges. Data are shown in the “2023 Open Enrollment Report”. Across all states, the average premium was $605 for the plans selected by individuals, up $20 (3%) from the prior year. About 90% of people received the Advance Premium Tax Credit (APTC) (which is based on income) to bring the net cost to individuals, down to about $129 per month, four dollars lower than in 2022. For those who qualify for the APTC, the difference (about $526 per month) is covered by the government (“Obamacare” and the American Rescue Plan). Average monthly premium net cost for those who qualified for the APTC was $102 per month on the federal Healthcare.gov exchange, and $209 on the state-based marketplaces. The national average premium of $605 per month works out to $7,260 premium cost per year. Source report from CMS, undated.
In an March 2023 report, “Early 2023 Effectuated Enrollment Snapshot“, details by state are provided for the prior year’s 2022 enrollment.
Study by Milliman shows that cost-shifting from Medicare and Medicaid underpayments added $1,788 to a family health insurance cost in 2006-2007. This amounted to about 15% of the amount paid for hospital and physician costs for privately insured people. Premiums paid through employer-provided insurance were estimated to be 10.6% higher due to the cost-shifting. With medical inflation, the cost shift would be more than $2,700 in today’s dollars, or more than $225 on the monthly premium. Study was commissioned by the AHA (American Hospital Association), AHIP and Blue Cross Blue Shield Assn/Premera Blue Cross, released December 2008. Old study.
Estimates of the number and percent uninsured under age 65, by state and county for 2020, provided by the U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE) released August 2022. Once you’ve located your counties of interest, click on it to see the actual numbers and recent trends. The first year that subsidized insurance was available on the health insurance exchange was 2014. Uninsured rates in the US declined steadily from 2013 when the uninsured rate was 16.8% through 2016 when it reached a low of 10.0%. Since 2016, the average percent uninsured has crept up somewhat to 10.4% in 2020. Compare your county’s rate to your state and the US.
America’s Health Insurance Plans (AHIP) identifies factors that are expected to impact premium costs for individual plans in the Health Insurance marketplace for 2023. AHIP did not project increases for 2023. Instead, they identified factors such as increases in medical prices, increases in utilization, inflation, Covid-19, and insurance subsidies to make insurance more affordable. Published July 2022.
The Long-Term Uninsured in America report is useful for historical reference. It analyzes the number of people under age 65 without insurance, before Obamacare expanded coverage in 2014. Using MEPS data, the largest segments of US population without health insurance for 4 years (2009-2012) included Hispanics (18.5% of the under-65 population, but 42.2% of the 4-year uninsured); the Poor Income group (17.5% of population, but 27.2% of long-term uninsured); those in Fair/Poor Health (11.1% compared to those in Excellent Health at 6.1%) and 25-29 year olds (15.8% rate). AHRQ Statistical Brief #464, Dec. 2014
How does medical technology contribute to growth in the cost of healthcare? Technology-related changes in medical practice are estimated by the Congressional Budget Office (CBO) to account for about half of the long-term growth in health care spending. CBO pub. 2764 Technological Change and the Growth of Health Care Spending also discusses the contribution to rising costs from population aging, health insurance, rising personal income, price increases, defensive medicine and more. The report’s 75-year forecast predicts health spending will reach 49% of GDP at the rate we’re going in the US. One of our favorite classic reports, released January 2008.
Consumers can request their MIB record which is privately shared among health insurance companies. If you have applied for individually underwritten life, health, or disability insurance during the last 7 years, MIB may have a record on you. Call toll-free 1-866-692-6901 to get a copy of your record (automated system takes about 5 minutes). Formerly known as the Medical Insurance Bureau, MIB is an association of life insurance companies providing information and database management services to the life and health insurance industry.
Sourcebook for journalists outlines essentials of health policy. The large document from the nonprofit Alliance for Health Policy provides baseline information on a wide variety of healthcare issues, including long term care, mental health. Glossary included. Originally written with reporters and journalists in mind; updated 2017.
How much is spent on tobacco lobbying in 2021 and 2022? The Center for Responsive Politics (opensecrets.org) identified $31 million spent lobbying by the tobacco industry in 2021. Altria, a major e-cigarette manufacturer, and Philip Morris together spent $21 million of it. British American Tobacco and JUUL Labs spent $4.56M in 2021. Year-to-date spending reported through March 2022 was $7.25 million. Altria and Philip Morris spent $4,460,000 of the $7.25 million. See who else contributed those monies