In 2021, health spending in the United States reached approximately 4.3 trillion U.S. dollars, and private insurance accounted for around 28.5 percent of that figure. However, public health insurance, which includes the Medicare and Medicaid programs, combined for a share of around 38.5 percent.
The rising costs of health care coverage
U.S. national health expenditure continues to increase and is projected to exceed four trillion U.S. dollars in 2021. Hospital care and physician services have been the leading spending categories for several years and combined for more than half of all health spending in 2021. In the same year, federal and state governments made up 61 percent of national health expenditures, with the federal government’s share accounting for 27 percent.
The differences between Medicare and Medicaid
Medicare and Medicaid were both signed into U.S. law by President Johnson in 1965. Medicare is a health insurance program solely funded by the federal government. The plan was primarily created for all Americans aged 65 and older, regardless of their income. Medicaid is administered at a state level in accordance with some core federal requirements, but both fund the program. The plan provides health care to millions of Americans, and some states have expanded the Medicaid program to cover nearly all low-income adults under the age of 65.
Health spending distribution in the United States 2018 and 2021, by payer*
Characteristic
Private health insurance
Medicare
Medicaid
Other public health insurance
Out-of-pocket
Other third-party payers
2018
34.1%
20.6%
16.4%
3.8%
10.3%
8%
2019
31%
21%
16%
4%
11%
9%
2020
27.6%
20.1%
16.2%
3.8%
9.5%
12.4%
2021
28.5%
21.2%
17.3%
4%
10.2%
9.5%
Created with Highcharts 7.2.2Percentage of health spending34.1%34.1%31%31%27.6%27.6%28.5%28.5%20.6%20.6%21%21%20.1%20.1%21.2%21.2%16.4%16.4%16%16%16.2%16.2%17.3%17.3%3.8%3.8%4%4%3.8%3.8%4%4%10.3%10.3%11%11%9.5%9.5%10.2%10.2%8%8%9%9%12.4%12.4%9.5%9.5%Private health insuranceMedicareMedicaidOther public health insuranceOut-of-pocketOther third-party payers2018201920202021
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CHCF. (August 7, 2023). Health spending distribution in the United States 2018 and 2021, by payer* [Graph]. In Statista. Retrieved April 25, 2025, from https://www.statista.com/statistics/247517/projected-health-spending-distribution-in-the-us-by-payer/
CHCF. "Health spending distribution in the United States 2018 and 2021, by payer*." Chart. August 7, 2023. Statista. Accessed April 25, 2025. https://www.statista.com/statistics/247517/projected-health-spending-distribution-in-the-us-by-payer/
CHCF. (2023). Health spending distribution in the United States 2018 and 2021, by payer*. Statista. Statista Inc.. Accessed: April 25, 2025. https://www.statista.com/statistics/247517/projected-health-spending-distribution-in-the-us-by-payer/
CHCF. "Health Spending Distribution in The United States 2018 and 2021, by Payer*." Statista, Statista Inc., 7 Aug 2023, https://www.statista.com/statistics/247517/projected-health-spending-distribution-in-the-us-by-payer/
CHCF, Health spending distribution in the United States 2018 and 2021, by payer* Statista, https://www.statista.com/statistics/247517/projected-health-spending-distribution-in-the-us-by-payer/ (last visited April 25, 2025)
Health spending distribution in the United States 2018 and 2021, by payer* [Graph], CHCF, August 7, 2023. [Online]. Available: https://www.statista.com/statistics/247517/projected-health-spending-distribution-in-the-us-by-payer/
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