Medicare/Social Security 2024 Trustee Reports Released

On May 6, 2024, 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 June 1, 2024, usgovernmentspending.com updated its chart of the Medicare Outlook here based on data in the 2023 Medicare Trustees Report.  You can download the data and also view selected Medicare Trustee forecasts going back to 2005.

On May 6, 2024, 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 June 1, 2024, usgovernmentspending.com updated its chart of the Social Security Outlook here based on data in the 2024 OASDI Trustees Report.  You can download the data and also view selected OASDI Trustee forecasts going back to 1997.

Federal Budget for FY25 Released

On March 11, 2024, we updated usgovernmentspending.com with the numbers from the Public Budget Database in the Budget of the United States Government for Fiscal Year 2025. 

Here is how headline budget estimates for the upcoming FY 2024 fiscal year have changed since the release of the FY 2024 budget a year ago in Winter 2023.

Federal Budget Changes for 2024

$ billion	Estimate for 2024 in FY2024 Budget	Estimate for 2024 in FY2025 Budget	Change
Federal Outlays	$6,371.8	$6,940.9	+$569.1
Federal Receipts	$4,802.5	$5,081.6	+$279.1
Federal Deficit	$1,569.4	$1,859.4	+$290.0

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 2029 come from the Outlays table in the Public Budget Database and were updated on usgovernmentspending.com on March 11, 2024.

Account level budget authority estimates through FY 2029 come from the Budget Authority table in the Public Budget Database and were updated on usgovernmentspending.com on March 11, 2024. 

Agency Debt Update for 2023

On March 11, 2024, usgovernmentspending.com updated its data for agency debt from the Federal Reserve Board database. Data is now available for the period 1945-2023. You can see our Agency Debt page here, and a comparison with the official "on-the-books" debt here.

For the period 2024 to 2029 usgovernmentspending.com has "guesstimated" the agency debt, assuming that it increases at the same rate as it did in 2022 to 2023.

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.

US GDP for 2023 Updated

On January 19, 2024 usgovernmentspending.com updated its GDP series with the latest data from the Bureau of Economic Analysis, under "Supplemental Information and Data" including nominal US GDP for third quarter 2023 of $25.464 trillion and real US GDP  for third quarter 2023 of $20.015 trillion in 2017 dollars. Real GDP is now expressed in 2017 dollars.

Up to now, usgovernmentspending.com has shown GDP for calendar years. But the OMB forecast for US GDP in Table 10.1 - Gross Domestic Product and Deflators Used in the Historical Tables uses GDP for the US federal government's fiscal year that ends every year on September 30. So we have changed GDP to the US fiscal year.

Thus GDP, real and nominal, looks like this:

• US GDP source from 1790 to 1928 is calendar GDP from measuringworth.com.
• US GDP source from 1929 to 1946 is calendar GDP from the Bureau of Economic Analysis, under "Supplemental Information and Data"
• US GDP source from 1947 to the present is third quarter GDP from the Bureau of Economic Analysis, under "Supplemental Information and Data."

usgovernmentspending.com computes inflation rate as:

((This Year GDP - Last Year GDP)/Last Year GDP - (This Year Real GDP - Last Year Real GDP)/Last Year Real GDP)*100.

Medicaid Update for FY 2022

On December 13, 2023, 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 1960 to 2022. On January 12, 2024, usgovernmentspending.com updated its Medicaid data.

Item	2022 Estimate	2022 Actual
Federal Medicaid	$591.9 bn	$591.9 bn
State Medicaid (net)	$274.7 bn	$213.8 bn
Total Medicaid	$866.6 bn	$805.7 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 2022) to the last year in the Historical Tables of the federal budget (for the FY 2024 budget that is 2028). So we have developed "guesstimates" of Medicaid spending going out to 2028, 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.

US, State Population Update for 2023

On December 28, 2023 the US Census Bureau released its US national and state population estimates for July 1, 2023.  On December 29, 2023 usgovernmentspending.com updated its US and state population data as follows:

• We updated 2021 and 2022 population data from US and states using data from US Census National Population Totals and Components of Change 2021-2022 in file NST-EST2022-POP.xlsx.
• We updated 2010-2020 population data for US and states using data from US Census Bureau Population Estimates: Vintage 2020, State Population Totals, in file nst-est2020.xlsx.
• We projected 2022 thru 2028 for the US and states assuming population rate change for 2021-22 using US Census Bureau Population Projection Tables, in file np2023-t1.xlsx (2023 projection).

usgovernmentspending.com uses population data in computing per capita spending and revenue data. You can see per capita spending data in a chart here, and in a table of spending here.

You can check the data update schedule here.

Federal Deficit, Receipts, Outlays Actuals for FY 2023

On October 20, 2023, the US Treasury reported in its Monthly Treasury Statement (and xlsx) for September that the federal deficit for FY 2023 ending September 30, 2023, was $1,675 billion. Here are the numbers, including total receipts, total outlays, and deficit compared with the numbers projected in the FY 2024 federal budget published in February 2023:

Federal Finances FY 2023 Outcomes
	Budget billions	Outcome billions
Receipts	$4,802	$4,439
Outlays	$6,371	$6,134
Deficit	$1,569	$1,675

usgovernmentspending.com now shows the new numbers for total FY 2022 total outlays and receipts on its Estimate vs. Actual page.

The Monthly Treasury Statement includes "Table 4: Receipts of the United States Government, September 2022 and Other Periods." This table of receipts by source is used for usgovernmentspending.com to post details of federal receipt actuals for FY 2022.

This MTS report on FY 2023 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 2023 and Other Periods". Subfunction amounts don't get reported until the FY25 budget in February 2024. Until then usgovernmentspending.com estimates actual outlays by "subfunction" for FY 2023 by factoring subfunction budgeted amounts for FY23 by the ratio between relevant actual and budgeted "function" amounts where actual outlays by subfunction cannot be gleaned from the Monthly Treasury Statement.

Final detailed FY 2023 actuals will not appear on usgovernmentspending.com until the FY 2025 federal budget is published in February 2024 with the actual outlays for FY 2023 in Historical Table 3.2--Outlays by Function and Subfunction.

State FY23 Taxes Update

On October 21, 2023 usgovernmentspending.com updated FY2023 state revenue with quarterly tax data released by the US Census Bureau on September 11, 2023.  Local tax data was updated by assuming that local taxes for 2023 changed by the same percent as state taxes of the same type.

$ billion	FY2023 Estimate	FY2023 Actual
State Income Tax Revenue	$641	$329
Total State Revenue	$3,050	$2,501

State and local spending projections for FY2024 to FY2028 have been reestimated using the "Guesstimate" method.

Federal Tax Collections by State for 2022

On July 21, 2023 we updated the federal tax collections by state for 2020, 2021, 2022, using IRS data from SOI Tax Stats - Gross Collections, by Type of Tax and State - IRS Data Book Table 5.

You can see current Federal Revenue by State here.

State and Local Finances for 2021

On June 30, 2023 we updated the state and local spending and revenue for FY 2021 using the new Census Bureau State and Local Government Finances summaries for FY 2021 released on June 28, 2023.  (See also Annual Survey of State and Local Government Finances). The release 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 FY2021 are now actual historical spending as reported by the Census Bureau.  Previously state spending and revenue for FY2021 were actual, and local spending and revenue were estimated.  The following table shows the difference between estimated and actual local spending and revenue for FY2021:

FY 2021	Estimated $ billion	Actual $ billion
Local Spending	$2,058	$2,203
Local Revenue	$1,545	$1,642

We have updated the "guesstimated" state and local finances for FY2022-28 as indicated in our "guesstimate" blog entries.

We have also updated data for individual local government units with data for 2021. 

Medicare/Social Security 2023 Trustee Reports Released

On March 31, 2023, 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 June 29, 2023, usgovernmentspending.com updated its chart of the Medicare Outlook here based on data in the 2023 Medicare Trustees Report.  You can download the data and also view selected Medicare Trustee forecasts going back to 2005.

On March 31, 2023, 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 June 29, 2023, usgovernmentspending.com updated its chart of the Social Security Outlook here based on data in the 2023 OASDI Trustees Report.  You can download the data and also view selected OASDI Trustee forecasts going back to 1997.

CBO Long Term Budget Outlook for 2023

On June 28, 2023 the Congressional Budget Office released its annual Long Term Budget Outlook for 2023, which projects federal spending and revenue out to 2053.  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.

Gross State Product for 2022

The US Bureau of Economic Analysis (BEA) released its Gross State Product (GSP) data for 2022 on March 31, 2023.

Usgovernmentspending.com has updated its individual state GSPs for 2022 for each state using the projected national GDP numbers from Table 10.1 in the Historical Tables for the Federal FY2024 Budget and the historical GDP data series from the BEA as a baseline.

Click here to view a complete list of US states and their 2022 GSP growth rates.

Process:

1. Click on link.
2. Click on "Interactive Data" link
3. Click on "Interactive Tables: GDP by State" link
4. Click on "Annual Gross Domestic Product (GDP) by State"
5. Click on Gross Domestic Product (GDP) summary
6. Areas: Select "All Areas"
7. Statistic: Select "Real GDP..." and "Current-dollar GDP..."
8. Click on Next Step button
9. Time Period: Select "All Years"
10. Click on Next Step button
11. Click on Download Data button
12. Select CSV 

Medicare Part C Update from 2023 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 2023 that was released at the end of March 2023. 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 2023 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 2023 before and after today's update.

Budgeted Outlays in percent GDP	Part A	Part B	Part C	Part D	Total Medicare
FY2023 before update	0.76	0.59	1.53	0.35	3.25% GDP
FY2023 after update	0.75	0.59	1.45	0.34	3.15% GDP

The update indicates a  small increase in budgeted Medicare Part C over the previous estimate in the Medicare Trustees Report in 2022.

US Gross Output for 2022 Released

On April 15, 2023, usgovernmentspending.com updated its Gross Output series with the latest data from the Bureau of Economic Analysis, including nominal Gross Output for calendar 2022 of $45.9628 trillion. Gross Output for some years previous to 2022 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.

Process:

1. Click on link.
2. Click on "Underlying Detail Tables." 
3. Click on "view detail levels tables... in XLSX format."
4. Click on "Gross Output by Industry" link
5. Save .xlsx file.

Agency Debt Update for 2022

On April 2, 2023, usgovernmentspending.com updated its data for agency debt from the Federal Reserve Board database. Data is now available for the period 1945-2022. You can see our Agency Debt page here, and a comparison with the official "on-the-books" debt here.

For the period 2022 to 2028 usgovernmentspending.com has "guesstimated" the agency debt, assuming that it increases at the same rate as it did in 2021 to 2022.

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 FY24 Released

On March 10, 2023, we updated usgovernmentspending.com with the numbers from the Public Budget Database in the Budget of the United States Government for Fiscal Year 2024. 

Here is how headline budget estimates for the upcoming FY 2023 fiscal year have changed since the release of the FY 2023 budget a year ago in Winter 2021.

Federal Budget Changes for 2023

$ billion	Estimate for 2023 in FY2023 Budget	Estimate for 2023 in FY2024 Budget	Change
Federal Outlays	$5,792.1	$6,371.8	+$579.7
Federal Receipts	$4,638.2	$4,802.5	+$164.3
Federal Deficit	$1,153.9	$1,569.4	$315.5

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 2028 come from the Outlays table in the Public Budget Database and were updated on usgovernmentspending.com on March 10, 2023.

Account level budget authority estimates through FY 2028 come from the Budget Authority table in the Public Budget Database and were updated on usgovernmentspending.com on March 10, 2023.

US GDP for 2022 Updated

On March 3, 2023 usgovernmentspending.com updated its GDP series with the latest data from the Bureau of Economic Analysis, under "Supplemental Information and Data" including nominal US GDP for calendar 2022 of $25.464 trillion and real US GDP  for calendar 2022 of $20.015 trillion in 2012 dollars. Real GDP is now expressed in 2012 dollars. GDP for years going back to 2015 have been revised by BEA.

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

State Spending for 2021

 On January 6, 2023 the US Census Bureau released data on state finances for FY 2021 here and here, including spending and revenue for each individual state and for all states combined.

On January 7, 2023 we updated state and local spending and revenue data for FY2021 through FY2027 as follows:

1. We replaced "guesstimated" state spending and revenue data for FY2021 using the new FY2021 data from the Census Bureau.
2. We replaced "guesstimated" local spending and revenue data for FY 2021 with estimates for each spending and revenue category using the trends in state finances between FY 2020 and FY 2021.
3. We replaced "guesstimated" state revenue data for FY 2022 with data from the Census Bureau's quarterly state tax summary here.
4. We replaced "guesstimated" local revenue data for FY 2022 with estimates for each category using trends for each category of state revenue between FY 2020 and FY 2021.
5. We replaced "guesstimated" state and local spending and revenue for FY 2022 thru FY2027 with new guesstimates based on the latest Census Bureau data for FY 2021 state finances and FY 2022 quarterly tax data.

But there is a problem.

Up through 2018 the Census Bureau reports state government pensions with item codes: X11, X12, X14. And it reported employee retirement income and contributions with item codes: X01, X02, X05, X08. 

No more. 

Instead the Census Bureau reports the following item codes: X01, X30, X40, X52, X70.

But we can't find the current "code lists" that are used in the Census Bureau's State Government Finances report. The Code List page only has the old code list. As of this hour.

But, using advanced juggle-ology, it seems that: 

Code X40 replaces X11, X12, and X14 to yield pension payments. This almost balances with overall Total Spending for the US and sample states.

Codes X01, X30, X52, X70 replace X01, X02, X05, X08 to yield pension contributions and income. This almost balances overall Total Revenue for the US and sample states.

So the state finances data on usgovernmentspending.com published for 2020 contains juggled data. 

Here is the comparison of our "guesstimate" vs. "actual:"

State Finances for FY2021
Estimate vs. Actual

$ billion	Guesstimate	Actual
Spending	$2,228	$2,265
Revenue	$2.060	$2,101

We expect the Census Bureau to release local spending and revenue data for FY 2021 not earlier than Summer 2023.

Medicaid Update for FY 2021

 On January 6, 2023, 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 1960 to 2021. On January 7, 2023, usgovernmentspending.com updated its Medicaid data.

Item	2021 Estimate	2021 Actual
Federal Medicaid	$520.6 bn	$520.6 bn
State Medicaid (net)	$241.5 bn	$213.4 bn
Total Medicaid	$762.1 bn	$734.0 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 2021) to the last year in the Historical Tables of the federal budget (for the FY 2023 budget that is 2027). So we have developed "guesstimates" of Medicaid spending going out to 2027, 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.