| The nation’s health care tab is projected to hit nearly $9 trillion by 2034 and account for more than one-fifth of the economy over the next decade, a new analysis from federal actuaries published Wednesday afternoon in Health Affairs found. That’s up from $5.7 trillion in health spending, representing 18.4 percent of GDP, in 2025. In 2026, health spending is projected to continue growing by 6.3 percent, fueled by continued strong utilization of hospital services, doctors’ visits and the cost of prescription drugs. → The analysis from the Centers for Medicare and Medicaid Services also found that health expenses are expected to rise an average of 5.4 percent each year over the next decade — set to outpace overall economic growth over the same period. Medicare is expected to be the biggest driver of spending growth. Program spending is projected to more than double from $1.2 trillion in 2025 to nearly $2.4 trillion in 2034, growing an average of 7.7 percent annually as baby boomers continue aging into the program. Why it matters: The CMS projections suggest that recent cost-control efforts may slow spending growth in some programs, but they do little to alter the long-term trajectory of rising health care costs driven by an aging population, the increased use of medical services, and a growing demand for high-cost drugs such as cancer treatments and GLP-1 weight loss medications. WHAT TO WATCH - The insured rate: The portion of Americans with health insurance will fall to 90.5 percent in 2034, down from an all-time high of nearly 93 percent in 2023. More than 33 million Americans are projected to be without insurance in 2034.
Republicans enacted legislation called the One Big Beautiful Bill last year that’s expected to cut nearly $1 trillion from Medicaid over the next decade and result in millions of additional uninsured Americans. CMS also pointed to the expiration of enhanced Affordable Care Act subsidies that helped people afford their insurance. - Decline in privately insured: Americans transitioning from employer-sponsored health coverage into Medicare is just part of a projected decline in people with private health insurance projected over the next decade. CMS told reporters Wednesday that the “final edge” of baby boomers are expected to reach age 65 by 2029.
- Drug pricing reforms: There’s a near-term spending surge in prescription drugs — 11.1 percent growth in 2025 and an estimated 8.2 percent in 2026 — that will abate over the next decade, to an average of a 5.7 percent per-year increase.
While provisions in the Inflation Reduction Act — including a limit to how much people enrolled in Medicare Part D plans can spend out of pocket on drugs each year — reduce costs for patients, it puts “upward pressure” on federal Medicare spending. The law’s Medicare negotiation provisions also decrease the cost of drugs overall, but also reduce the amount of drugmaker rebates collected by the government, according to the report. Actuaries also factored the most-favored-nation drug pricing agreements that pharma giants cut with the Trump administration into their overall assessment, Jacqueline Fiore, an economist at CMS, told reporters Wednesday. However, she said the agency does “not have specific estimates for the impact of these policies.” - Medicare spending: Overall health insurance spending is expected to grow by 5.8 percent annually over the next decade, driven largely by Medicare spending. CMS projects that Medicare spending will increase about 7.7 percent each year. Furthermore, Medicare’s share of national health expenditures is expected to rise from 21 percent in 2024 to 26 percent in 2034.
- GLP-1 spending: John Poisal, the deputy director of the National Health Statistics Group within the CMS Office of the Actuary, told reporters Wednesday that the market for GLP-1 drugs used to treat conditions including diabetes and obesity is expected to “saturate a little bit” after 2026, which is expected to bring down the growth of spending on — and use of — the medications.
- Skin substitutes!: The actuaries credited a recent physician payment rule that capped Medicare reimbursement for skin substitutes — which are made from placenta and used as wound dressings — with an overall drop in spending growth for health services. The annual spending growth in professional services decreased from 5.8 percent in 2025 to 2 percent in 2026. (I’ve written about these reforms — and the industry pushback — in several issues of Health Brief.)
- Biggest spending jumps: While spending increases on hospital stays, physician services and medications hover at an average of about 5 percent or 6 percent per year, home health services represent the category with consistently high health spending growth — increasing by an average of more than 8 percent per year.
- Medicaid cost shifts: While federal Medicaid spending is expected to grow by about 4.7 percent annually over the next decade, state and local spending on the Medicaid program for low-income Americans will grow by an average of 5.6 percent per year. The number-crunchers attribute this to an end to covid-era federal funding and policies included in the One Big Beautiful Bill, which puts limits on state-directed payments, restrictions on provider taxes and imposes new work requirements for some patients.
Whoop, which makes wristbands that track health metrics, has reached a détente with the Food and Drug Administration over a product feature that reads and displays a user’s blood pressure. - Last July, the Food and Drug Administration sent Whoop a warning letter over marketing its wristband’s ability to provide insights about a user’s blood pressure, arguing that the agency hadn’t authorized the feature for “any use, including for the measurement or estimation of a user’s blood pressure.” The company pushed back, arguing it is a “wellness feature, not a medical device.”
- Then, earlier this year, the agency issued new regulatory guidance for “low risk” products that “promote a healthy lifestyle,” in a move seen as directly beneficial to companies including Whoop. It gives wearable companies more latitude to provide readings around blood pressure and glucose levels as long as they’re used solely for wellness, rather than medical, purposes.
- Now, after Whoop agreed to make changes to its “Blood Pressure Insights” feature, the FDA is telling the company that it will no longer pursue enforcement actions.
The company’s CEO, Will Ahmed, called it a “major milestone” for the company in a LinkedIn post Wednesday, noting that Whoop “appreciated the FDA’s engagement throughout this process.” “When the FDA first issued the warning letter, many experts advised Whoop that removing the feature was the only path forward. But we believed in the strength of science and our responsibility to the members who rely on it,” Ahmed wrote. “That conviction guided our approach throughout this process.” → The company is adjusting the way its blood pressure readings are displayed in its app “to prevent any confusion that the feature is classifying blood pressure in a clinical manner,” a Whoop spokesperson said. But a user’s blood pressure reading will still appear alongside colors ranging from green to yellow to red. “The science is clear that understanding changes in blood pressure has significant wellness benefits,” Ahmed said in the social media post. Key context: Regulators still haven’t clearly defined where the line between a “wellness” feature ends and the classification of a “medical” device begins, leaving a gray area for some manufacturers that could also prompt confusion among consumers trying to interpret their own health data. → The FDA truce comes just a few months after the company announced it had raised $575 million in a recent late-stage funding round — including from high-level investors such as medical device company Abbott and the Mayo Clinic — and bringing its overall valuation to more than $10 billion. French officials announced Wednesday that a doctor who had traveled to the Democratic Republic of Congo on a humanitarian mission has tested positive for Ebola, the European country’s first case of the current outbreak. The person is being treated in a specialized facility and remains in stable condition, according to health officials. → Global health officials say the Ebola outbreak that began in May is already breaking records, with more than 1,000 confirmed cases reported in its first month in Congo, according to the latest from The Post’s Rael Ombuor in Nairobi. Rael reports that experts fear the outbreak could become one of the deadliest among the 17 Ebola outbreaks recorded since the virus was first identified in the 1970s. Read more: “France reports first Ebola patient as cases in Africa surge above 1,000.” WHAT WE’RE READING “New Orleans hospital destroyed by Katrina to be reborn as a science hub,” The Post’s Susan Svrluga writes. “Construction of US-backed Ebola quarantine unit in Kenya is stopped,” writes Stephanie Soucheray for CIDRAP. “The $50B rural health transformation fund is pushing many hospitals to shrink,” Michael Brady reports for Healthcare Dive. “Justice Department Unveils $6.5 Billion Healthcare Fraud Crackdown,” Sabrina Siddiqui and Christopher Weaver report at the Wall Street Journal. This newsletter is published by WP Intelligence, The Washington Post’s subscription service for professionals that provides business, policy and thought leaders with actionable insights. WP Intelligence operates independently from the Washington Post newsroom. Learn more about WP Intelligence. | 
