(Story updated at 6:15 p.m. Eastern)
In 2015, the U.S. federal government spent more on healthcare than on Social Security for the first time.
The Affordable Care Act's expansion of Medicaid and the growing availability of subsidies for exchange plans are driving much of the higher spending.
Enrollment in the ACA's insurance exchanges will hover around 13 million in 2016, the Congressional Budget Office said in an expanded economic report Monday, down from its previous estimate of 21 million but still above HHS' most optimistic projection.
But the exchanges represent just a small slice of federal healthcare spending. Medicare and Medicaid will eat more into the federal budget over the next decade, yet per-person costs will remain constant with historical norms.
The CBO also noted that medical-device companies and health insurers could save billions of dollars over the next decade if the temporary moratoriums on certain taxes are made permanent—underscoring a potentially huge return on those groups' lobbying investments.
The nonpartisan budget analysis group, led by Republican-appointed Keith Hall, released a teaser version of its January budget outlook last week. It found that spending on federal healthcare programs—including Medicare, Medicaid, the ACA and the Children's Health Insurance Program—will increase by 11% this year and will be a major reason why mandatory federal expenses will rise over the next decade.
Last year, net federal spending on healthcare totaled $936 billion compared with $866 billion for Social Security, CBO's numbers crunchers said. The amount spent on healthcare is only expected to increase in the coming years due largely to Medicaid and the ACA's fledgling marketplaces.