The U.S. healthcare market combined $5.3 trillion in national health spending, 6,100 hospitals, and millions of healthcare jobs in the latest reported periods. The figures below show how spending is distributed, who has coverage, where care is delivered, and how the market is expected to change.
Contents
- Market size and spending
- Payers and household coverage
- Age, gender, and geographic differences
- Marketplace enrollment and affordability
- Hospitals and care capacity
- Hospital costs and payment pressure
- Healthcare jobs and future demand
Market size and spending
CMS Historical data reported that U.S. health care spending grew 7.2% in 2024, reaching $5.3 trillion. Spending was $15,474 per person, and health spending represented 18.0% of U.S. GDP. These are national totals for 2024, so they describe the size of the U.S. market rather than the spending of an individual household.
The largest reported payer categories in 2024 were private health insurance and Medicare. Private health insurance spending grew 8.8% to $1,644.6 billion, representing 31% of total national health expenditures. Medicare spending grew 7.8% to $1,118.0 billion and represented 21% of total national health expenditures. Medicaid spending grew 6.6% to $931.7 billion, or 18% of the total.
Out-of-pocket spending grew 5.9% to $556.6 billion in 2024 and accounted for 11% of total national health expenditures. The category covering other third-party payers and programs plus public health activity declined 7.0% to $590.5 billion, also representing 11% of total national health expenditures.
| 2024 spending category | Amount | Growth or share |
|---|---|---|
| Private health insurance | $1,644.6 billion | 8.8% growth; 31% share |
| Medicare | $1,118.0 billion | 7.8% growth; 21% share |
| Medicaid | $931.7 billion | 6.6% growth; 18% share |
| Other third-party payers and programs plus public health activity | $590.5 billion | 7.0% decline; 11% share |
| Out-of-pocket spending | $556.6 billion | 5.9% growth; 11% share |
CMS’s National Health Expenditure Fact Sheet also reported $1,634.7 billion in hospital expenditures in 2024, up 8.9%. Hospital expenditure growth slowed from 10.6% in 2023 to 8.9% in 2024. Physician and clinical services expenditures grew 8.1% to $1,109.7 billion; that growth accelerated from 7.4% in 2023. Prescription drug spending increased 7.9% to $467.0 billion, down from 10.8% growth in 2023.
Payers and household coverage
The CMS National Health Expenditure Fact Sheet reported the 2020 sponsorship mix as 31% from the federal government, 28% from households, 18% from private business, 16% from state and local governments, and 6% from other private revenues. These percentages describe the sponsorship of total health spending in 2020, not the 2024 payer amounts above.
CMS NHE Projections reported that the insured share of the U.S. population was 93.1% in 2023. Census Health Insurance Coverage 2024 reported that 92.0% of people in the United States, or 310 million people, had health insurance for some or all of 2024. Coverage categories can overlap because a person may have more than one type of coverage during a year.
In the Census 2024 results, private health insurance covered 66.1% of the population and public coverage reached 35.5%. Employment-based insurance covered 53.8%, while Medicare covered 19.1% and Medicaid covered 17.6%. Direct-purchase coverage covered 10.7% of the population. TRICARE covered 2.8%, and VA and CHAMPVA coverage covered 1.2%.
The distinction between the 93.1% insured share reported for 2023 by CMS and the 92.0% share reported by Census for 2024 reflects different published reports and measurement periods. Neither figure should be treated as a same-series year-over-year change without additional methodological detail.
Age, gender, and geographic differences
The CMS National Health Expenditure Fact Sheet reported substantial differences by age in 2020. Per-person personal health care spending for adults age 65 and older was $22,356. That was more than five times spending per child and almost 2.5 times spending per working-age person. Children were about 23% of the population but accounted for about 10% of personal health care spending. Adults age 65 and older were about 17% of the population and accounted for about 37% of personal health care spending.
Per-person spending for females was $10,887 in 2020, which was 14% more than spending for males. These age and gender figures are 2020 personal health care measures, not 2024 national spending totals.
Per capita personal health care spending also varied by state and region in 2020. Utah recorded $7,522 per person, while New York recorded $14,007. New York’s per capita spending was 37% higher than the national average, and Utah’s was about 26% lower. Regional figures included $12,728 in New England, $12,577 in the Mideast, $8,497 in the Rocky Mountain region, and $8,587 in the Southwest.
Between 2014 and 2020, average per capita personal health care spending growth was 6.1% per year in New York and 3.0% per year in Wisconsin. Medicare expenditures per beneficiary were $13,652 in Florida and $8,726 in Vermont in 2020. Medicaid expenditures per enrollee were $12,314 in North Dakota and $4,754 in Georgia.
California’s personal health care spending was $410.9 billion in 2020, equal to 12.2% of total U.S. personal health care spending. Wyoming represented 0.1% of the national total. Health spending equaled 28.7% of West Virginia’s state GDP and 11.7% of Washington state’s GDP in 2020.
Marketplace enrollment and affordability
CMS’s Marketplace 2024 Open Enrollment Report recorded 21.4 million consumers who selected or were automatically re-enrolled in coverage during the 2024 Marketplace open enrollment period. HealthCare.gov Marketplaces accounted for 16.4 million selections, while state-based Marketplaces accounted for 5.1 million. Total selections were 31% higher than in the 2023 open enrollment period.
New consumers selecting Marketplace coverage rose 41% to 5.2 million in 2024. Among consumers who reported race or ethnicity, 22% identified as Hispanic or Latino and 9% identified as Black. The report also recorded 9.6 million more consumers receiving advance premium tax credits in 2024 than in 2021.
The average monthly premium after advance premium tax credits fell from $164 in 2021 to $111 in 2024. In 2024, 44% of Marketplace consumers—nearly 9.4 million people—selected a plan costing $10 or less per month after the credit. Half of all Marketplace consumers received cost-sharing reductions. The report counted 1.5 million Marketplace consumers who reported household income above 400% of the federal poverty level.
CMS’s Effectuated Enrollment Report counted 20.8 million consumers with effectuated Marketplace coverage in February 2024. That was 33% higher than February 2023 and 50% higher than February 2022. In February 2024, 19.3 million Marketplace enrollees received advance premium tax credits, equal to 93% of Marketplace enrollees. Cost-sharing-reduction enrollment reached 10.4 million consumers, up 37% from February 2023.
Hospitals and care capacity
The American Hospital Association’s Fast Facts on U.S. Hospitals 2026 reported 6,100 U.S. hospitals in 2024. U.S. community hospitals totaled 5,121, including 2,984 nongovernment not-for-profit hospitals, 1,224 investor-owned for-profit hospitals, and 913 state and local government hospitals. The same report counted 210 federal government hospitals, 656 nonfederal psychiatric hospitals, and 113 other hospitals.
All U.S. hospitals had 907,216 staffed beds in 2024, including 775,297 staffed beds in community hospitals. Total admissions reached 35,658,583, with 33,553,725 admissions in community hospitals. Community hospitals included 1,797 rural hospitals and 3,324 urban hospitals; 3,567 community hospitals were in a system.
The AHA said its data were provided by more than 6,200 hospitals and 400 health care systems, with more than 1,300 hospital data points directly from the source. Those coverage notes describe the AHA data collection context and should not be read as additional hospital totals.
Hospital costs and payment pressure
The AHA Costs of Caring 2024 report divided average hospital expenses in 2023 into labor, supplies, drugs, and other costs. Labor accounted for 60%, or $839 billion. Supplies accounted for 13%, or $181 billion; drugs accounted for 8%, or $115 billion; and other costs accounted for 19%, or $269 billion.
Economy-wide inflation grew 12.4% between 2021 and 2023, while Medicare inpatient reimbursement increased 5.2%. Days cash on hand for hospitals and health systems declined 28.3% since the start of 2022. Hospitals admitted nearly 137 million patients in emergency departments in 2022 and delivered more than 3.5 million babies.
Medicare and Medicaid underpayments totaled nearly $130 billion in 2022. Medicare paid 82 cents for every dollar hospitals spent caring for patients in 2022, and Medicare shortfalls were almost $100 billion. In 2023, average payments for inpatient behavioral health services were 34.3% below costs across all payers. Average payments for outpatient burn and wound services were 42.9% below costs.
Hospital supply expenses totaled $146.9 billion in 2023, after medical supply expenses increased by $6.6 billion from 2022 to 2023. Hospitals spent approximately $51.1 billion on contracted staff in 2023. Hospital employee compensation grew 45.0% from 2014 to 2023, while inflation grew 28.7% over the same period.
Healthcare jobs and future demand
The Bureau of Labor Statistics reported that overall employment in healthcare occupations is projected to grow much faster than the average for all occupations from 2024 to 2034. About 1.9 million openings per year are projected in healthcare occupations over that period. The median annual wage in May 2024 was $83,090 for healthcare practitioners and technical occupations and $37,180 for healthcare support occupations. The healthcare support median was below the $49,500 median for all occupations.
Registered nurses held about 3.4 million jobs in 2024, according to BLS Registered Nurses. BLS Healthcare Occupations Spotlight reported 14.7 million people age 16 and older employed in healthcare occupations in 2022, equal to 9.3% of total employment. Personal care aides numbered 1.4 million and nursing assistants numbered 1.2 million in 2022.
BLS’s advanced practice registered nurse profile counted about 382,700 nurse practitioner, nurse anesthetist, and nurse midwife jobs in 2024. Nurse practitioners accounted for 320,400, nurse anesthetists for 53,800, and nurse midwives for 8,600. The median annual wage for APRNs was $132,050 in May 2024.
The BLS OEWS chart reported 1,029,460 home health and personal care aide jobs in home health care services in May 2024. General medical and surgical hospitals employed 1,843,130 registered nurses, 425,740 nursing assistants, 155,670 medical and health services managers, and 151,210 clinical laboratory technologists and technicians. Outpatient care centers employed 166,840 registered nurses and 29,330 nurse practitioners. Specialty hospitals employed 72,010 registered nurses, while psychiatric and substance abuse hospitals employed 30,420 psychiatric technicians and 41,760 registered nurses.
The BLS 2024–34 projections reported that the population age 65 and older is projected to increase from 59.7 million in 2024 to 72.5 million in 2034. Home health and personal care aide employment is projected to add 739,800 jobs from 2024 to 2034.
CMS NHE projections put average national health expenditure growth at 5.8% over 2024–33, compared with projected average GDP growth of 4.3%. The health spending share of GDP is projected to rise from 17.6% in 2023 to 20.3% in 2033. CMS also reported projected 2024 NHE growth of 8.2%. For 2027–32, personal health care price inflation and utilization growth are projected to produce 5.6% health spending growth, while the rest of the economy is projected to grow 4.1%.