Federal healthcare spending is projected to more than double in the coming decade, according to federal budget projections (PDF).

Total federal healthcare spending on so-called mandatory programs—including on Medicare and Medicaid—will grow from $847 billion in the current fiscal year to $1.8 trillion in fiscal 2022, according to the Congressional Budget Office.

The CBO report included the healthcare projections as part of an annual accounting of federal spending and revenue trends the nonpartisan office is required to produce.

The provisions of the 2010 federal healthcare law that will have spending impacts include new state health insurance exchanges, on which the federal government will spend $645 billion over the 10-year span. Also, the law's Medicaid provisions are projected to drive growth in its enrollment from 67 million to 95 million people and federal spending on it from $275 billion to $605 billion over the next 10 years.

The projection also includes an “alternative fiscal scenario,” based on likely congressional actions, such as extending a popular tax cut that is scheduled to expire. A significant healthcare item under the alternate scenario is the additional $360 billion Medicare is likely to spend over the 10 years above the baseline projections if it replaces a planned 27.4% cut in March with a continuation of current rates.

“If those payments were increased over time, the impact on Medicare outlays would be even greater,” according to the report.