3 Takeaways About 2018 Health Care Spending

Health Afffairs blogger Katie Keith points to growing numbers of un- and uninsured Americans
Peter Wehrwein

Health care experts and commentators are still figuring out what to make of the national health expenditure data for 2018 that was released last week. The federal government figures show that spending grew 4.6% to $3.6 trillion in 2018,  which works out to $11,172 per person and 17.7% of GDP.

Katie Keith, who writes the “Following the ACA” blog for Health Affairs, plucked out three takeaways from the welter of facts  and figures that she said would be most relevant to her readers.

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Katie Keith

  1. Private health insurance spending increased by 5.8% to $1.2 trillion (and 34% of total health spending) in 2018, an increase from the 4.9% in 2017. Keith noted that CMS attributes the increase primarily to reinstatement of the ACA’s health insurance tax, or HIT, for 2018, following a moratorium on the tax in 2017. She said industry lobbyists and business organizations are pushing for another HIT moratorium in 2020.
  2. Health care spending is going up even as the uninsured rate rises; typically, lack of insurance suppresses people's use of medical services.  CMS found that the number of uninsured people increased by 1 million, meaning 30.7 million people were uninsured in 2018. “The CMS report is yet another confirmation of coverage losses in recent years,” Keith wrote.
  3. Consumer spending on out-of-pocket costs accounted for 10% of total health care spending, or $375.6 billion, in 2018. "Though there has been significant progress in reducing the uninsured rate, underinsurance rates—where people have health insurance but face high out-of-pocket medical expenses relative to their income—continue to climb, especially for those enrolled in job-based coverage,” she noted.