On September 3, 2014, the CMS Office of the Actuary published a report in Health Affairs spelling out its projections for health care expenditure growth over the next ten years. The authors of the report expect health spending growth to remain slow at 3.6% in 2013, which is the fifth year in a row of spending growth under 4%. The report blames the slow growth on a  lukewarm economic recovery, government sequestration and increases in private health insurance cost-sharing requirements.

For 2014, the growth in health spending is expected to be 5.6% since 9 million Americans will obtain insurance coverage under the Affordable Care Act (“ACA”) through Medicaid expansions or the health insurance exchanges. Parallel to the increased coverage will be a reduction of out-of-pocket spending by 0.2%. Additionally, annual growth of 6% is expected for 2015 through 2023 due to further implementation of the ACA’s coverage expansion, healthier economic growth and an aging baby-boomer population. While this growth rate is larger than recent years, it is still slower than the growth averaged over the past two decades. However, since health spending is projected to grow 1.1% faster than the average economic growth until 2023, health care’s share of the nation’s gross domestic product may increase up to 19.3% in 2023 from 17.2% in 2012.