National Health Expenditure Projections, 2025–34: Strong Utilization Growth Initially, Legislative Impacts Later Authors: Jacqueline A. Fiore jacqueline.fiore@cms.hhs.gov, Andrea M. Sisko, John A. Poisal, Sheila D. Smith, Gigi A. Cuckler, Andrew J. Madison, Sean P. Keehan, Kathryn E. Rennie, and Nicholas J. Feehley

https://www.healthaffairs.org/doi/10.1377/hlthaff.2026.00642?utm_campaign=july+2026+issue&utm_medium=email&_hsenc=p2ANqtz--YdEjqBEyzYy6KnB6NyRXwiwQoRss4N7h0eaaukgurdy02RqNQhGUP2gOOJ_21b7n2eFN9R2TKtElvgTOx8nSY8JJehg&_hsmi=425789085&utm_content=ahead+of+print&utm_source=hasu By 2034, national health spending is projected to total nearly $9.0 trillion and to represent 20.6 percent of the economy, compared with $5.3 trillion and 18.0 percent in 2024. The rate of national health spending growth during this period is influenced by continued elevated use of medical services and goods through 2026; major legislative changes that affect insurance coverage and spending through 2028; and continued demographic shifts toward public programs, mainly Medicare. The insured share of the population is expected to be 90.5 percent in 2034, compared with 91.8 percent in 2024.