The Record

Care

Brick is the national health bill per person — CMS National Health Expenditures, as dollars a month. Steel is what households paid at the counter: out of pocket, not the premium. The pie on the cards is who financed the bill. 2025–26 are CMS projections.

The bill

$1,458

per person / month

At the counter

$152

$153 in 2026 $

Government paid

48%

of national bill

At this year

Donald Trump

2026*

Donald Trump

The billAt the counter
$0$400$800$1200$160089939701050913172125

By administration

George H. W. Bush

Bush 41

1989–1992

$245

Gov
33%
Household
35%
Employers
32%

Counter $44 · $109 in 2026 $

Bill Clinton

Clinton

1993–2000

$342

Gov
37%
Household
32%
Employers
31%

Counter $49 · $103 in 2026 $

George W. Bush

Bush 43

2001–2008

$554

Gov
40%
Household
31%
Employers
30%

Counter $73 · $125 in 2026 $

Barack Obama

Obama

2009–2016

$755

Gov
45%
Household
29%
Employers
26%

Counter $88 · $127 in 2026 $

Donald Trump

Trump 1

2017–2020

$953

Gov
47%
Household
28%
Employers
25%

Counter $102 · $135 in 2026 $

Joe Biden

Biden

2021–2024

$1,185

Gov
48%
Household
28%
Employers
24%

Counter $126 · $142 in 2026 $

Donald Trump

Trump 2

2025–2026

$1,416

Gov
48%
Household
27%
Employers
25%

Counter $148 · $151 in 2026 $

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Notes

The bill is CMS National Health Expenditures per capita, as dollars per month. At the counter is out-of-pocket — not premiums.

  • The bill. CMS National Health Expenditures per capita, dollars per month. 1990 and 2000–2024 are Table 1. 1989 and 1991–1999 divide Table 5 NHE totals by CMS population interpolated between the 1980, 1990, and 2000 published benchmarks. This is the national bill — hospitals, physicians, drugs, insurance overhead, public health, investment — not a family premium.
  • At the counter. CMS Table 5-2 household out-of-pocket health spending per capita / 12. Copays, deductibles, and care paid without insurance. Not the worker’s share of the premium, not Medicare Part B, not FICA.
  • Who paid. CMS Table 5 (1987–2024) and Table 16 projections, type of sponsor. Household = premiums workers pay + Medicare payroll tax + OOP. Government = federal + state/local. Employers = private business + other private residual. 2020 is the COVID spike in the federal share.
  • 2025–2026. CMS Office of the Actuary NHE projections, June 2026 (NHE $16,486 and $17,496 per person). Historical accounts run through 2024.
  • 2026 dollars. Out-of-pocket on the administration cards is converted to July 2026 dollars with BLS CPI-U. The chart stays in the dollars people paid that year.

Source: CMS National Health Expenditures per person · out-of-pocket at the counter · 2025–26 projected