National health expenditures rise 7.2% in 2024, reaching $5.3 trillion

United States health care expenditures reached $5.3 trillion in 2024, or $15,474 per person, according to a new study published today in Health Affairs by the National Health Statistics Group in the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS).

The findings were also presented during a CMS media briefing on the National Health Expenditure Accounts through 2024, led by Micah Hartman, statistician in the National Health Services Group at CMS and lead author of the study, along with Don Metz, interim editor-in-chief and executive publisher of Health Affairs.

Total health care spending grew 7.2% in 2024, slightly below the 7.4% growth recorded in 2023. Health care spending accounted for 18% of the U.S. gross domestic product, up from 17.7% in 2023, reflecting strong growth in personal health care spending on medical goods and services. Personal health care spending rose 8.9%, marking the fastest two consecutive years of growth since 1991 and 1992.

Insurance coverage remained historically high, though it declined slightly from its peak. In 2024, 91.8% of the population was insured, down from 92.5% in 2023. Private health insurance enrollment increased from 207.0 million in 2023 to 214.3 million in 2024, driven largely by growth in Affordable Care Act Marketplace plans.

Marketplace enrollment reached 21.1 million people in 2024, up from 16.2 million in 2023 and 9.8 million in 2019. Hartman attributed this increase primarily to enhanced federal subsidies.

“The main driver of the increase in Marketplace coverage has been the enhanced marketplace subsidies, which lowered enrollees’ costs,” Hartman said during the briefing. “Marketplace spending totaled $149.5 billion in 2024, with the federal government financing 78%, or $116.6 billion, through subsidies.”

In contrast, Medicaid enrollment declined by 7.9 million people in 2024, falling from a peak of more than 92.2 million in 2023 to 84.3 million, as states resumed eligibility redeterminations following the end of the COVID-19 public health emergency. Despite lower enrollment, Medicaid spending per enrollee surged 16.6%, compared with 6.5% growth in 2023, driven by higher-cost enrollees, increased provider payment rates, and growth in state-directed payments.

Health policy experts say the post-pandemic Medicaid “unwinding” has reshaped coverage patterns nationwide, with many former enrollees transitioning to employer-sponsored or Marketplace plans. While overall coverage remains high, the shift has raised concerns about continuity of care for individuals navigating changes in insurance status.

The federal government remained the largest sponsor of health care spending, accounting for $1.7 trillion in expenditures in 2024. Hospital care represented the largest category of spending, totaling $1.6 trillion, or 31% of national health care expenditures. Medicare spending accounted for 21% of total expenditures at $1.1 trillion, while Medicaid represented 18%, or $931.7 billion.

Looking ahead, the study’s authors note that health care spending trends remain uncertain and will be shaped by economic conditions, demographic shifts, and emerging technologies.

“Developments in artificial intelligence, cancer treatments, and expanding use of weight-loss medications and preventive health initiatives may affect the health care system in unexpected ways,” Hartman and his colleagues wrote.