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U.S. Health Spending Forecast to Reach Nearly $9 Trillion by 2034

CMS actuaries say rising use of costly drugs, faster growth in Medicare enrollment, and expiring ACA premium subsidies will push healthcare to roughly one-fifth of GDP.

Overview

  • The Centers for Medicare & Medicaid Services Office of the Actuary published projections Wednesday showing national health spending will grow at about 5.4% a year and reach $8.97 trillion by 2034.
  • Healthcare's share of the economy is expected to rise from 18.0% in 2024 to about 20.6% in 2034 as spending outpaces GDP growth.
  • Medicare is projected to be the fastest-growing payer, with average annual spending growth near 7.7% from 2025–2034 because of an aging population and higher per-enrollee costs.
  • Retail prescription drugs are the fastest-growing spending category, driven by high use of newer costly medicines such as GLP-1s and expensive oncology drugs, which raised drug spending sharply in 2024–2026.
  • Policy changes will reshape near-term trends: the FY2026 Physician Fee Schedule is set to cut skin substitute payments by more than 90%, and the scheduled end of enhanced ACA premium tax credits after 2026 is projected to reduce direct-purchase enrollment and raise the uninsured population by about 3 million; projections remain sensitive to future laws, market behavior, and clinical use.