Health Affairs October 29, 2025
Federal health spending plays a central role in the nation’s long-term fiscal outlook. In 2024, Medicare, Medicaid, and the Children’s Health Insurance Program accounted for 31 percent of all federal program spending—$1.8 trillion—and this total is projected to rise significantly over the next 30 years. At the same time, private health insurance spending per enrollee is expected to grow by over 50 percent by 2032. These unsustainable trends—occurring without commensurate improvements in population health— create a burning need for reform: Without meaningful change, rising health care costs will increasingly strain household budgets, crowd out other federal and state priorities, and undermine the nation’s long-term fiscal stability.
Against this urgent backdrop, the United States Government Accountability Office issued its 2024 report,...
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