ECONOMIC REPORT OF THE PRESIDENT

3
Figure 4-29
Trends in Real Health Care Prices, by Service, 1960–2016
Average Annual Percent Growth
4
2.5
Pre-ACA 50 Years (Mar 1960–Mar 2010)
Pre-ACA Decade (Mar 2000–Mar 2010)
Post-ACA Period (Mar 2010–Present)
2
1
0
1.7
1.1
1.8
0.2 0.3
1.5
0.3
0.1
1.2
1.9
-1
All Health Care
Goods and Services
Hospital and SNF
Services
-0.5
Outpatient Services
Pharmaceuticals
Source: National Income and Product Accounts; CEA calculations.
4-31.23 Real per enrollee spending in private insurance has risen at an average
rate of just 1.5 percent per year during the post-ACA period, well below
the pace recorded over either the five-year period that immediately preceded
the ACA or the five-year period before that. Medicare spending has followed
a similar pattern, with real Medicare spending per enrollee actually falling at
an average annual rate of 0.3 percent per year during the post-ACA period.
(Per enrollee spending growth in Medicaid has also fallen during the post-
ACA period, although these trends are more complicated to interpret due
to significant compositional changes in the types of individuals enrolled in
Medicaid during both the pre-ACA and post-ACA periods.)
Per enrollee spending growth has slowed markedly across all major
service categories, including hospital services, physician services, and prescription
drugs, as illustrated in Figure 4-32. Notably, where comparable
data are available, the decline in real per enrollee spending growth exceeds
the decline in the growth of real health care prices described previously,
indicating that much of the decline in per enrollee spending growth reflects
slower growth in the utilization of health care services. For example, the
23 The spending amounts attributed to each insurance type in the National Health Expenditure
Accounts reflect only the payments made by the insurer. They do not include amounts borne
by enrollees such as deductibles, coinsurance, or copayments. Including these amounts would
not change the main conclusions reached here.
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