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The burdensome costs of medical care, prescription drugs and health insurance have become dominant issues in the 2020 presidential campaign. But a new report from the Department of Health and Human Services shows the nation remains in a period of relatively slow growth in health spending. Health spending in the United States rose by 4.6 percent to $3.6 trillion in 2018 — accounting for 17.7 percent of the economy — compared to a growth rate of 4.2 percent in 2017. Federal officials said the slight acceleration was largely the result of reinstating a tax on health insurers that the Affordable Care Act imposed but Congress had suspended for a year in 2017. Faster growth in medical prices and prescription drug spending were also factors, they said, but comparatively minor. (Goodnough and Sanger-Katz, 12/5)

The federal government and households were the largest sponsors, each contributing 28% to the total spending in the year. The cost of health as a share of the economy decreased 0.2 points to 17.7% in 2018. Increased net costs drove up private health insurance spending by 5.8% to $1.2 trillion in 2018, faster than the 4.9% growth in the year before. (12/5)

Private businesses, meanwhile, shelled out nearly $727 billion on health care, an increase of 6.2% -- the fastest growth rate since 2003. More than three-quarters of that spending is on employer contributions for insurance premiums, which rose at a quicker pace than in 2017. Spending by Medicare, Medicaid and private health insurance grew faster in 2018 partly because of the reinstatement of the health insurance tax, an Affordable Care Act provision that Congress suspended for 2017. The tax was expected to raise $14.3 billion in 2018, according to the Internal Revenue Service. (Luhby, 12/5)

Between the lines: U.S. health care spending climbed again not because people went to the doctor or hospital more frequently, but because the industry charged higher prices. And private health insurers didn't do a particularly good job negotiating lower rates. (Herman, 12/5)

The number of people without insurance rose by 1 million in 2018 for the second consecutive year, with 30.7 million individuals uninsured. Democrats have criticized Mr. Trump for his efforts—including ending billions of dollars in payments to insurers and expanding health plans that are cheaper but don’t provide the health law’s consumer protections—to roll back the 2010 Obama-era health law that expanded coverage to an estimated 20 million people. While the overall acceleration in national health-care spending wasn’t that large relative to other years, an Affordable Care Act tax accounts for most of the increase, according to the report. The tax, an annual fee on all health insurers, is among several imposed under the law to cover its estimated 10-year cost of more than $1 trillion. (Armour, 12/5)

Prices for prescription drugs edged down by 1% last year, a rare result driven by declines for generics and slow, low growth in the cost of brand-name medications, the government said Thursday. Though modest, it was the first such price drop in 45 years, according to nonpartisan economic experts at the federal Department of Health and Human Services, who deliver an annual report on the nation's health care spending. (Alonso-Zaldivar, 12/5)

The slowing of drug price increases “means buyers are being smarter and more sensitive” looking for generic alternatives and other ways to avoid high-priced medicines, said Dan Mendelson, founder of Avalere Health, a D.C.-based consulting firm. “It’s tempting to declare victory when spending growth attenuates,” Mendelson said. But in part because health plans are shifting more of the burden to their customers, “the polling this year very clearly shows we are in a health-care affordability crisis, and consumers are facing a big squeeze on their finances,” he said. (Goldstein, 12/5)

Other observers argued that healthcare spending growth remains too high, with inflation-adjusted growth of 2.5% only slightly behind GDP growth of 2.9%. They say that while efforts by payers and providers to control costs may have moderated spending increases, there is still a long way to go to make healthcare affordable and worth the money. "I suppose it's a good sign that healthcare's percentage of total GDP dropped. It's not squeezing out as much spending on other things, but it's still squeezing out a lot," said Steve Wojcik, vice president of public policy for the National Business Group on Health. (Meyer, 12/5)

In the Democratic fight over "Medicare for All" and in the push to lower health care costs in general, hospitals usually fly under the radar, as politicians tend to focus on drug companies and insurers. But the report shows hospitals make up a much larger share of health care spending than drug companies. (Weixel, 12/5)

Kaiser Health News: KHN’s ‘What The Health?’: We Spend HOW MUCH On Health Care?

Health spending in the U.S. grew to $3.6 trillion in 2018, according to a new report from the federal government. The rate of growth — 4.6% — was up slightly from 2017’s 4.2%, despite the fact that nearly a million more Americans lacked insurance. Meanwhile, Congress has less than two weeks to finish a year’s worth of work, including the spending bills required to keep the government running and promised legislation to address “surprise” medical bills and prescription drug prices. (12/5)