By Mary Agnes Carey
Wed, Sep 3 2014
National health spending will increase modestly over the next decade, propelled in part by the gradual rebound of the U.S. economy and the growing ranks of Americans who became insured under the health law, government actuaries projected Wednesday.
But those growth rates are not as high as what the country saw for the two decades before the Great Recession crippled the U.S. economy at the end of 2007, according to the report from the Centers for Medicare & Medicaid Services Office of the Actuary and published in the journal Health Affairs.
The actuaries estimate that health spending grew just 3.6 percent in 2013, the fifth year of historically low rates of spending growth. But it will accelerate to 5.6 percent in 2014. They also forecast that the average growth rate for 2015-2023 would be 6 percent. That is up just slightly from last year.
The findings also suggest that health care will outpace growth in the gross domestic product over the next decade. Health care’s share of GDP, which has remained fairly stable since 2009, will rise from 17 percent in 2012 to more than 19 percent in 2023.
While some health care analysts and Obama administration officials have said the Affordable Care Act is reducing costs, CMS actuaries are no longer measuring the effects of the law on health care spending.
"We are no longer quantifying the impacts of the Affordable Care Act on national health spending," Andrea M. Sisko, the lead author on the study, told reporters at a briefing on the findings. "Now that the Affordable Care Act has been in place for well over four years, it is becoming increasingly difficult to accurately estimate … what the world would look like in the absence" of the law.
Sisko also said it is too soon to estimate the impact of the health law's delivery system changes on the nation's health care system.
Paul Ginsburg, a public policy professor at the Schaeffer Center for Health Policy and Economics at the University of Southern California, said the report illustrates that "the recession and the very slow recovery from the recession are important determinants of health spending trends …. There's a been a lot of debate over the past year or two about how much of the slowdown we've experienced has been from the business or the economic cycle and how much is due to real changes in health care. My sense is it’s both. This very steep recession and this very slow recovery from it, especially when you look at the very low growth in wages, is something that has definitely depressed health care spending. The implication of higher deductibles, of greater cost sharing, that’s important as well."