Medicaid Update for FY2019

On December 16, 2020, the Centers for Medicare and Medicaid Services (CMS) published its annual report on National Health Expenditures and its NHE Tables includes data on Medicaid from 1966 to 2019. On December 16, 2020, usgovernmentspending.com updated its Medicaid data.

Item	2019 Estimate	2019 Actual
Federal Medicaid	$409.4 bn	$409.4 bn
State Medicaid (net)	$219.1 bn	$204.1 bn
Total Medicaid	$628.5 bn	$613.5 bn

The federal Medicaid number comes from the Federal Budget Subfunction 558: Grants to states for Medicaid. The state contribution comes from the NHE Tables.

usgovernmentspending.com publishes "guesstimates" of state and local spending from the latest year published by the Census Bureau (currently FY 2018) to the last year in the Historical Tables of the federal budget (for the FY 2021 budget that is 2025). So we have developed "guesstimates" of Medicaid spending going out to 2025, assuming that the overall Medicaid spending increases at the same rate as the federal "Grants to States for Medicaid" increases.

National Health Expenditure data is updated each year in mid December.

Federal Deficit, Receipts, Outlays Actuals for FY 20

On October 16, 2020, the US Treasury reported in its Monthly Treasury Statement (and xlsx) for September that the federal deficit for FY 2020 ending September 30, 2020, was $3,132 billion. Here are the numbers, including total receipts, total outlays, and deficit compared with the numbers projected in the FY 2021 federal budget published in February 2020, and the "guesstimates" made by usgovernmentspending.com in late September 2020:

Federal Finances FY 2020 Outcomes
	Budget billions	Guesst. billions	Outcome billions
Receipts	$3,706	$3,463	$3,420
Outlays	$4,790	$6,371	$6,552
Deficit	$1,083	$2,908	$3,132

usgovernmentspending.com now shows the new numbers for total FY 2020 total outlays and receipts on its Estimate vs. Actual page.

The Monthly Treasury Statement includes "Table 4: Receipts of the United States Government, September 2019 and Other Periods." This table of receipts by source is used for usgovernmentspending.com to post details of federal receipt actuals for FY 2020.

This FTS report on FY 20 actuals is a problem for usgovernmentspending.com because this site uses Historical Table 3.2--Outlays by Function and Subfunction from the Budget of the United States as its basic source for federal subfunction outlays. But the Monthly Treasury Statement only includes "Table 9. Summary of Receipts by Source, and Outlays by Function of the U.S. Government, September 2020 and Other Periods". Subfunction amounts don't get reported until the FY22 budget in February 2021. Until then usgovernmentspending.com estimates actual outlays by "subfunction" for FY 2020 by factoring subfunction budgeted amounts for FY20 by the ratio between relevant actual and budgeted "function" amounts where actual outlays by subfunction cannot be gleaned from the Monthly Treasury Statement.

On top of that, the unbudgeted spending to fight the COVID-19 virus is tucked into various places where you'd least expect it. We have tried to unearth these monies in the FTS and translate them into subfunction amounts.

Final detailed FY 2020 actuals will not appear on usgovernmentspending.com until the FY 2022 federal budget is published in February 2021 with the actual outlays for FY 2020 in Historical Table 3.2--Outlays by Function and Subfunction.

State and Local Finances for FY 2018

On October 6, 2020 we updated the state and local spending and revenue for FY 2018 using the new Census Bureau State and Local Government Finances summaries for FY 2018 released on September 16, 2020.  This includes state and local spending for the United States as a whole and the 50 individual states and the District of Columbia.

State and local spending and revenue for FY2018 are now actual historical spending as reported by the Census Bureau.  Previously state spending and revenue for FY2018 were actual, and local spending and revenue were estimated.  The following table shows the difference between estimated and actual local spending and revenue for FY2018:

FY 2019	Estimated $ billion	Actual $ billion
Local Spending	$1,955	$1,961
Local Revenue	$1,392	$1,399

We have updated the "guesstimated" state and local finances for FY2019-25 as indicated in our "guesstimate" blog entries.

We have also updated data for individual local government units with data for 2018.

CBO Long Term Budget Outlook for 2020

On September 21, 2020 the Congressional Budget Office released its annual Long Term Budget Outlook for 2020, which projects federal spending and revenue out to 2050.  As before, the CBO study shows that federal health-care programs and interest costs will eat the budget, with federal spending exceeding 25 percent GDP by the mid 2030s while federal revenue stays below 19 percent GDP.

UsGovernmentspending.com has updated its chart of the CBO Long Term Budget Outlook here.  You can download the data and also view CBO Long Term Budget Outlooks going back to 1999.

State FY20 Taxes Update

On September 22, 2020 usgovernmentspending.com updated FY2020 state revenue with quarterly tax data released by the US Census Bureau on September 9, 2020.  Local tax data was updated by assuming that local taxes for 2020 changed by the same percent as state taxes of the same type.

$ billion	FY2020 Estimate	FY2020 Actual
State Income Tax Revenue	$487	$487
Total State Revenue	$2,099	$2,088

State and local spending projections for FY2021 to FY2025 have been reestimated using the "Guesstimate" method.

Federal Revenue by State for 2019

On August 26, 2020, we updated usgovernmentspending.com with the numbers from "SOI Tax Stats - Gross Collections, by Type of Tax and State, Fiscal Year - IRS Data Book Table 5" of the IRS Data Book for 2019.  The data can be viewed on the Federal Revenue by State page here.

Add Federal Intergovernmental Transfers for Individual States

Up to now, usgovernmentspending.com has shown so-called "intergovernmental transfers" for displays of spending for the gross finances of all states, but not for individual states.

But the Census Bureau publishes, in its Annual Survey of State and Local Government Finances, numbers for intergovernmental transfers, both for all states together in the United States as a whole, and for each individual states.

In response to a request from a user, usgovernmentspending.com now shows intergovernmental transfers for individual states. But the amount is shown as a value of federal spending and as a negative value of intergovernmental transfer. This is done to avoid double counting, because the proceeds of each intergovernmental transfer is already shown in the spending on programs at the state and local level.

For instance, for education spending for Alabama in 2017, the latest year with data, we show:

$ billion	Federal	Gov. Xfer.	State	Local	Total
Education	1.69	-1.69	6.22	7.94	14.16

But there is a problem. The total shown in the Historical Table 12.3 in the Federal Budget for federal grants to state and local governments is not the same as the amount of intergovernmental transfers. For instance, in 2017 the Feds show total education grants to states and local governments at $57.3 billion, but the total of education intergovernmental transfers in the Census Bureau data under code B21 is $90.7 billion. Right now, we do not know what the difference means.

Revised State and Local Finances for 2012-2017

Recently the Census Bureau has updated its State and Local Government Finance Historical Datasets and Tables for the years 2012 thru 2017. usgovernmentspending.com updated its state and local data on June 3, 2020. The changes are typically minor, as shown in the following table for state and local finances for the entire United States showing Total Spending and Total Revenue in billions of dollars.

Year	State Spending			State Revenue			Local Spending			Local Revenue
$ billion	Before	After	Diff	Before	After	Diff	Before	After	Diff	Before	After	Diff
2012	1,497	1,504	+4	1,368	1,338	-30	1,651	1,651	0	1,077	1,074	-3
2013	1,516	1,526	+10	1,668	1,696	+28	1,662	1,662	0	1,155	1,153	-2
2014	1,550	1,574	+24	1,814	1,807	-7	1,712	1,713	+1	1,229	1,220	-9
2015	1,634	1,639	+5	1,555	1,559	+4	1,763	1,763	0	1,206	1,199	-7
2016	1,692	1,703	+9	1,499	1,500	+1	1,814	1,826	+12	1,212	1,215	+3
2017	1,765	1,764	-1	1,892	1,872	0	1,895	1,897	+2	1,336	1,336	0

Similar changes may apply to individual states.

The spending and revenue data for individual cities, counties, and special districts has also been updated.

Medicare/Social Security 2020 Trustee Reports Released

On April 22, 2020, the Center for Medicare Services released its annual Medicare Trustees Report, which projects Medicare spending out to 2095.  As in the past, the report shows that federal health-care programs will eat the budget.

In this report the Trustees forecast that Medicare will top out at a little above 6 percent of GDP in the 2080s.

On May 14, 2020, usgovernmentspending.com updated its chart of the Medicare Outlook here based on data in the 2020 Medicare Trustees Report.  You can download the data and also view selected Medicare Trustee forecasts going back to 2005.

On April 25, 2020, the Social Security Administration released its annual OASDI Trustees Report, which projects Social Security spending out to 2095.  As in the past, the report shows that Social Security spending will max out at about 6 percent of GDP. UsGovernmentspending.com uses the Supplemental Single Year Tables.

On May 14, 2020, usgovernmentspending.com updated its chart of the Social Security Outlook here based on data in the 2020 OASDI Trustees Report.  You can download the data and also view selected OASDI Trustee forecasts going back to 1997.

Medicare Part C Update from 2020 Medicare Trustees Report

Usgovernmentspending.com has updated its estimate of Medicare Part C, the Medicare Advantage program using data in the Medicare Trustees Report of 2020 that was released April 22, 2020. You can see the results here.

The Budget of the United States Government reports Medicare outlays as a single line item, subfunction 571 in Historical Table 3.2, but Usgovernmentspending.com shows a breakdown of the Medicare program into its constituent parts, as follows:

1. Part A: Hospital Insurance
2. Part B: Supplementary Medical Insurance
3. Part C: Medicare Advantage
4. Part D: SMI Drug Plan

These data are constructed from data in the Public Budget Database, which provide details on Part A, Part B, and Part D, with Part C embedded in the Part A and Part B outlays. Part C is constructed from data in Table IV.C2 in the Medicare Trustees Report 2020 which reports the payments made to private Medicare health plans and the projected payments in future years.

You can inspect the extracted data from Medicare Trustees Reports Table IV.C2 here. And see the blog entry that introduced the Medicare Part C breakout to usgovernmentspending.com here.

Here is a breakdown of Medicare budgeted outlays on usgovernmentspending.com for FY 2021 before and after today's update.

Budgeted Outlays in percent GDP	Part A	Part B	Part C	Part D	Total Medicare
FY2021 before update	0.91	0.73	1.14	0.36	3.14% GDP
FY2021 after update	0.86	0.68	1.24	0.36	3.14% GDP

The update indicates a  small increase in budgeted Medicare Part C over the previous estimate in the Medicare Trustees Report in 2019.

Gross State Product for 2019

The US Bureau of Economic Analysis (BEA) released its Gross State Product (GSP) data for 2019 on April 7, 2020.

Usgovernmentspending.com has updated its individual state GSPs for 2019 and projected nominal and real GSP through 2025 for each state using the projected national GDP numbers from Table 10.1 in the Historical Tables for the Federal FY2021 Budget and the historical GDP data series from the BEA as a baseline.

As before we have projected individual state GSPs out to 2025 by applying a factor to reflect each state's deviation from the national growth rate. (E.g. In 2014 the national real GDP expanded by 2.4 percent. But North Dakota grew by 6.3 percent, a deviation of nearly 4 percent. The deviation is reduced by 40 percent for each year after 2014, making the assumption that each state will slowly revert to the national norm.)

Click here to view a complete list of US states and their 2019 GSP growth rates.

Monthly Coronavirus COVID-19 Update

Starting today, April 10, 2020, usgovernmentspending.com is publishing a Coronavirus/COVID-19 update page showing the month-to-month response of the US federal government in spending, revenue, and deficit.

The page uses the Monthly Treasury Statement (MTS) issued by the US Department of the Treasury at 2:00pm on the 8th business day of the month.

For the month of March 2020 the MTS shows the following:

US Federal Finances for March 2020
	FY 2019 $ billion	FY 2020 $ billion	Difference $ billion
Outlays	$375.8	$355.9	-$19.9
Receipts	$228.8	$236.8	+$8.0
Deficit	$147.0	$119.1	-$27.9
Debt Increase	-$86.4	$283.8	+$370.2

Only significance: $370 billion increase in Federal Debt.

Next monthly update will be Monday May 11, 2020.

US Gross Output for 2019 Released

On April 09, 2020, usgovernmentspending.com updated its Gross Output series with the latest data from the Bureau of Economic Analysis, including nominal Gross Output for calendar 2019 of $37.807 trillion. Gross Output for some years previous to 2019 have been revised by BEA.

usgovernmentspending.com reports Gross Output on its Spending Details page and permits charting of spending and revenue as "percent of Gross Output".

The Gross Output series extends back to 1947.

State Finances for 2018

On February 25, 2020 the US Census Bureau released data on state finances for FY 2018 here and here, including spending and revenue for each individual state and for all states combined.

On April 1, 2020 we updated state and local spending and revenue data for FY2018 through FY2025 as follows:

1. We replaced "guesstimated" state spending and revenue data for FY2018 using the new FY2018 data from the Census Bureau.
2. We replaced "guesstimated" local spending and revenue data for FY 2018 with estimates for each spending and revenue category using the trends in state finances between FY 2017 and FY 2018.
3. We replaced "guesstimated" state revenue data for FY 2019 with data from the Census Bureau's quarterly state tax summary here.
4. We replaced "guesstimated" local revenue data for FY 2019 with estimates for each category using trends for each category of state revenue between FY 2017 and FY 2018.
5. We replaced "guesstimated" state and local spending and revenue for FY 2019 thru FY2025 with new guesstimates based on the latest Census Bureau data for FY 2018 state finances and FY 2019 quarterly tax data.

State Finances for FY2018
Estimate vs. Actual

$ billion	Guesstimate	Actual
Spending	$1,839	$1,849
Revenue	$1,963	$1,943

We expect the Census Bureau to release local spending and revenue data for FY 2018 not earlier than Summer 2020.

US GDP for 2019 Updated

On March 26, 2020, usgovernmentspending.com updated its GDP series with the latest data from the Bureau of Economic Analysis, under "Supplemental Information and Data" including nominal GDP for calendar 2019 of $21.428 trillion and real GDP  for calendar 2019 of $19.073 trillion in 2012 dollars. Real GDP is now expressed in 2012 dollars. GDP for years going back to 2014 have been revised by BEA.

Usgovernmentspending.com uses the BEA GDP data series from 1929 to the present and measuringworth.com as its GDP source from 1790 to 1928.

Agency Debt Update for 2019

On March 12, 2020, usgovernmentspending.com updated its data for agency debt from the Federal Reserve Board database. Data is now available for the period 1945-2019. You can see our Agency Debt page here, and a comparison with the official "on-the-books" debt here.

For the period 2020 to 2025 usgovernmentspending.com has "guesstimated" the agency debt, assuming that it increases at the same rate as it did in 2018 to 2019.

See "Federal 'Agency Debt' Added" for explanation of  data derivation.

Data is downloaded from the FRB data download page for "Financial Accounts of the United States (Z.1)" as follows.

1. Select a preformatted data package: "L.211 (A) Agency- and GSE-Backed Securities, n.s.a."
2. Click: Format package.
3. Select: 100 years.
4. Click: Go to Download.
5. Click: Download File.

Federal Budget for FY21 Released

On February 10, 2020, we updated usgovernmentspending.com with the numbers from the historical tables in the Budget of the United States Government for Fiscal Year 2021. Actual revenue for FY 2019 and estimated revenue through FY 2025 come from Historical Tables 2.1, 2.4, and 2.5. Actual spending for FY 2019 and estimated spending at the subfunction level through FY 2025 come from Table 3.2. Budget Authority estimates come from Table 5.1, federal debt estimates come from Table 7.1 and GDP estimates come from Table 10.1. Intergovernmental transfers come from Table 12.3.

Here is how headline budget estimates for the upcoming FY 2021 fiscal year have changed since the release of the FY 2020 budget a year ago in Winter 2019.

FY 2020 Federal Budget Changes Since 2019

$ billion	Estimate for 2020 in FY2020 Budget	Estimate for 2020 in FY2021 Budget	Change
Federal Outlays	$4,745.6	$4,789.8	+$44.2
Federal Receipts	$3,644.8	$3,706.3	+$61.5
Federal Deficit	$1,100.8	$1,083.4	-$17.4

You can see line item changes from budget to budget here. You can compare budget estimates with actuals here.

Account level spending estimates through FY 2025 come from the Outlays table in the Public Budget Database and were updated on usgovernmentspending.com on February 10, 2020.

Account level budget authority estimates through FY 2025 come from the Budget Authority table in the Public Budget Database and were updated on usgovernmentspending.com on February 10, 2020.