Medicare Blog

growth in medicare spending: what will the beneficiaries pay?

by Ms. Ernestine Mann Jr. Published 2 years ago Updated 1 year ago
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Thus, even without additional changes in policy, beneficiaries will bear a higher share of spending in the future. In real terms (using 2000 dollars), a striking increase of more than 80 percent is projected for the annual Part B premium, which will shoot up from $631 in 2000 to $1,151 in 2025.

Projected growth in Medicare Advantage spending
Rebates account for about 10 percent of Medicare Advantage payments in 2021 ($35 billion of $348 billion) and are projected to rise to 12 percent ($80 billion of $664 billion) in 2029.
Aug 17, 2021

Full Answer

What is the per capita spending growth rate for Medicare beneficiaries?

Including Part D spending, per capita spending grew at an average annual rate of 5.8 percent for beneficiaries ages 66 to 69 over these years, rising to 7.3 percent among beneficiaries ages 90 and older.

Why is Medicare spending growing so slowly?

In addition, although Medicare enrollment has been growing between 2 percent and 3 percent annually for several years with the aging of the baby boom generation, the influx of younger, healthier beneficiaries has contributed to lower per capita spending and a slower rate of growth in overall program spending.

How much does the government spend on Medicare each year?

Medicare spending was 15 percent of total federal spending in 2018, and is projected to rise to 18 percent by 2029. Based on the latest projections in the 2019 Medicare Trustees report, the Medicare Hospital Insurance (Part A) trust fund is projected to be depleted in 2026, the same as the 2018 projection.

How much has Medicare spending increased since 2000?

Average annual growth in Medicare spending per beneficiary was just 1.7 percent between 2010 and 2018, down from 7.3 percent between 2000 and 2010. Spending on each of the three parts of Medicare (A, B, and D) has grown more slowly in recent years than in previous decades (Figure 5).

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What is responsible for most of the Medicare spending growth?

Medicare is funded primarily from general revenues (43 percent), payroll taxes (36 percent), and beneficiary premiums (15 percent) (Figure 7). Part A is financed primarily through a 2.9 percent tax on earnings paid by employers and employees (1.45 percent each) (accounting for 88 percent of Part A revenue).

What percent of Medicare expenditures are funded by beneficiary premiums?

15 percentUnfortunately, the sum of those changes will not be sufficient to offset future cost growth. Premiums play only a modest role in funding the Medicare program. They financed 15 percent of Medicare's overall costs in 2021, about the same share as in 1970.

What is the expected growth of Medicare beneficiaries by the year 2030?

The Congressional Budget Office (CBO) projects that the share of all Medicare beneficiaries enrolled in Medicare Advantage plans will rise to about 51 percent by 2030. This analysis has been updated to reflect changes in methodology in how KFF calculates the total number of Medicare beneficiaries.

Do Medicare beneficiaries pay copayments?

Medicare beneficiaries are responsible for out-of-pocket costs such as copayments, or copays for certain services and prescription drugs. There are financial assistance programs available for Medicare enrollees that can help pay for your copays, among other costs.

How much do Medicare beneficiaries spend out of pocket on health care?

Medicare Beneficiaries' Spending for Health Care People covered by traditional Medicare paid an average of $6,168 for health care in 2018. They spent almost half of that money (47 percent) on Medicare or supplemental insurance premiums.

What percentage does Medicare pay?

You'll usually pay 20% of the cost for each Medicare-covered service or item after you've paid your deductible. If you have limited income and resources, you may be able to get help from your state to pay your premiums and other costs, like deductibles, coinsurance, and copays.

What are the negatives of a Medicare Advantage plan?

Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.

What happens when Medicare runs out in 2026?

The trust fund for Medicare Part A will be able to pay full benefits until 2026 before reserves will be depleted. That's the same year as predicted in 2020, according to a summary of the trustees 2021 report, which was released on Tuesday.

How many Medicare beneficiaries are there in 2021?

As of October 2021, the total Medicare enrollment is 63,964,675. Original Medicare enrollment is 36,045,321, and Medicare Advantage and Other Health Plan enrollment is 27,919,354. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.

How do I get my $144 back from Medicare?

Even though you're paying less for the monthly premium, you don't technically get money back. Instead, you just pay the reduced amount and are saving the amount you'd normally pay. If your premium comes out of your Social Security check, your payment will reflect the lower amount.

Does Medicare pay copays as secondary?

Medicare will normally act as a primary payer and cover most of your costs once you're enrolled in benefits. Your other health insurance plan will then act as a secondary payer and cover any remaining costs, such as coinsurance or copayments.

What is the Medicare copay for 2022?

2022 costs at a glance If you buy Part A, you'll pay up to $499 each month in 2022. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $499. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $274.

How fast will Medicare spending grow?

On a per capita basis, Medicare spending is also projected to grow at a faster rate between 2018 and 2028 (5.1 percent) than between 2010 and 2018 (1.7 percent), and slightly faster than the average annual growth in per capita private health insurance spending over the next 10 years (4.6 percent).

What percentage of Medicare is spending?

Key Facts. Medicare spending was 15 percent of total federal spending in 2018, and is projected to rise to 18 percent by 2029. Based on the latest projections in the 2019 Medicare Trustees report, the Medicare Hospital Insurance (Part A) trust fund is projected to be depleted in 2026, the same as the 2018 projection.

How is Medicare Part D funded?

Part D is financed by general revenues (71 percent), beneficiary premiums (17 percent), and state payments for beneficiaries dually eligible for Medicare and Medicaid (12 percent). Higher-income enrollees pay a larger share of the cost of Part D coverage, as they do for Part B.

How much does Medicare cost?

In 2018, Medicare spending (net of income from premiums and other offsetting receipts) totaled $605 billion, accounting for 15 percent of the federal budget (Figure 1).

Why is Medicare spending so high?

Over the longer term (that is, beyond the next 10 years), both CBO and OACT expect Medicare spending to rise more rapidly than GDP due to a number of factors, including the aging of the population and faster growth in health care costs than growth in the economy on a per capita basis.

What has changed in Medicare spending in the past 10 years?

Another notable change in Medicare spending in the past 10 years is the increase in payments to Medicare Advantage plans , which are private health plans that cover all Part A and Part B benefits, and typically also Part D benefits.

How is Medicare's solvency measured?

The solvency of Medicare in this context is measured by the level of assets in the Part A trust fund. In years when annual income to the trust fund exceeds benefits spending, the asset level increases, and when annual spending exceeds income, the asset level decreases.

When did Medicare per capita increase?

Between 2000 and 2011, Medicare per capita spending grew faster for beneficiaries ages 90 and older than for younger beneficiaries over age 65, both including and excluding spending on the Part D prescription drug benefit beginning in 2006.

Why is the analysis focusing on Medicare beneficiaries over age 65 rather than younger adults who qualify for Medicare?

The analysis focuses on Medicare beneficiaries over age 65 rather than younger adults who qualify for Medicare because of a permanent disability to develop a better understanding of the relationship between Medicare spending and advancing age. This study examines patterns of Medicare spending among beneficiaries in traditional Medicare rather ...

What percentage of Medicare beneficiaries were enrolled in 2011?

Because we lack comparable data for the 25 percent of beneficiaries enrolled in Medicare Advantage in 2011, it is not possible to assess whether patterns of service use and spending in traditional Medicare apply to the Medicare population overall. More information about the data, methods, and limitations can be found in the Methodology.

How much did Medicare spend in 2011?

Average Medicare per capita spending in 2011 more than doubled between age 70 ($7,566) and age 96 ($16,145). The increase in Medicare per capita spending as beneficiaries age can be partially, but not completely, explained by the high cost of end-of-life care.

Is Medicare spending data available for all people?

The analysis excludes beneficiaries who are age 65 because some of these beneficiaries are enrolled for less than a full year; therefore, a full year of Medicare spending data is not available for all people at this year of age. The analysis focuses on Medicare beneficiaries over age 65 rather than younger adults who qualify for Medicare because ...

Will population aging affect health care?

According to the Congressional Budget Office, population aging is expected to account for a larger share of spending growth on the nation’s major health care programs through 2039 than either “excess spending growth” or subsidies for the coverage expansions provided under the Affordable Care Act. 2. To inform discussions about Medicare’s role in ...

Does Medicare increase as you age?

As the U.S. population ages, the increase in the number of people on Medicare and the aging of the Medicare population are expected to increase both total and per capita Medicare spending. The increase in per capita spending by age not only affects Medicare, but other payers as well.

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Summary

  • Medicare, the federal health insurance program for nearly 60 million people ages 65 and over and younger people with permanent disabilities, helps to pay for hospital and physician visits, prescription drugs, and other acute and post-acute care services. This issue brief includes the most recent historical and projected Medicare spending data published in the 2018 annual repor…
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Health

  • In 2017, Medicare spending accounted for 15 percent of the federal budget (Figure 1). Medicare plays a major role in the health care system, accounting for 20 percent of total national health spending in 2016, 29 percent of spending on retail sales of prescription drugs, 25 percent of spending on hospital care, and 23 percent of spending on physician services.
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Cost

  • In 2017, Medicare benefit payments totaled $702 billion, up from $425 billion in 2007 (Figure 2). While benefit payments for each part of Medicare (A, B, and D) increased in dollar terms over these years, the share of total benefit payments represented by each part changed. Spending on Part A benefits (mainly hospital inpatient services) decreased ...
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Causes

  • Slower growth in Medicare spending in recent years can be attributed in part to policy changes adopted as part of the Affordable Care Act (ACA) and the Budget Control Act of 2011 (BCA). The ACA included reductions in Medicare payments to plans and providers, increased revenues, and introduced delivery system reforms that aimed to improve efficiency and quality of patient care …
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Effects

  • In addition, although Medicare enrollment has been growing around 3 percent annually with the aging of the baby boom generation, the influx of younger, healthier beneficiaries has contributed to lower per capita spending and a slower rate of growth in overall program spending. In general, Part A trust fund solvency is also affected by the level of growth in the economy, which affects …
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Impact

  • Prior to 2010, per enrollee spending growth rates were comparable for Medicare and private health insurance. With the recent slowdown in the growth of Medicare spending and the recent expansion of private health insurance through the ACA, however, the difference in growth rates between Medicare and private health insurance spending per enrollee has widened.
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Future

  • While Medicare spending is expected to continue to grow more slowly in the future compared to long-term historical trends, Medicares actuaries project that future spending growth will increase at a faster rate than in recent years, in part due to growing enrollment in Medicare related to the aging of the population, increased use of services and intensity of care, and rising health care pri…
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Funding

  • Medicare is funded primarily from general revenues (41 percent), payroll taxes (37 percent), and beneficiary premiums (14 percent) (Figure 7). Part B and Part D do not have financing challenges similar to Part A, because both are funded by beneficiary premiums and general revenues that are set annually to match expected outlays. Expected future increases in spending under Part B and …
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Assessment

  • Medicares financial condition can be assessed in different ways, including comparing various measures of Medicare spendingoverall or per capitato other spending measures, such as Medicare spending as a share of the federal budget or as a share of GDP, as discussed above, and estimating the solvency of the Medicare Hospital Insurance (Part A) trust fund.
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Purpose

  • The solvency of the Medicare Hospital Insurance trust fund, out of which Part A benefits are paid, is one way of measuring Medicares financial status, though because it only focuses on the status of Part A, it does not present a complete picture of total program spending. The solvency of Medicare in this context is measured by the level of assets in the Part A trust fund. In years whe…
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Benefits

  • A number of changes to Medicare have been proposed that could help to address the health care spending challenges posed by the aging of the population, including: restructuring Medicare benefits and cost sharing; further increasing Medicare premiums for beneficiaries with relatively high incomes; raising the Medicare eligibility age; and shifting Medicare from a defined benefit s…
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