May 7, 2024

Medicare’s Hospital Insurance Trust Fund Could Be Exhausted in 12 Years

Due to rising healthcare costs and the aging of the population, spending under the Medicare program will outpace its revenues, resulting in substantial cash deficits, according to the latest Trustees report. As a result, the Hospital Insurance (HI) Trust Fund, which finances Medicare Part A, will be depleted in 12 years. At that point, payments to participating hospitals and other providers would be reduced.

Below are the key takeaways from the report:

  1. The Hospital Insurance Trust Fund will be depleted by 2036, at which point payments to hospitals would be reduced by 11 percent. The trust fund had a balance of $209 billion at the end of 2023 and will run surpluses for the next few years. Soon after, costs will outpace revenues and the trust fund will incur deficits until it is exhausted.
  2. Medicare’s Hospital Insurance trust fund will be depleted in 2036


  3. Rising healthcare costs and an aging population are driving Medicare costs. As the nation’s population ages, enrollment in Medicare will continue to climb and add to program costs. Older Americans spend more on healthcare, on average, than younger Americans and are not subject to payroll taxes once they stop working. The combination of the long-term trend of rapid healthcare cost growth and population aging accelerates HI spending, which is projected to climb from 1.5 percent of GDP in 2024 to 1.9 percent in 2036.
  4. Medical spending increases rapidly with age


  5. The largest source of Medicare’s financing comes from the federal government’s general fund. When looking at Medicare as a whole (including the Supplementary Medical Insurance program and provision of prescription drugs), nearly half of the program’s receipts come from the general fund rather than dedicated payroll taxes. Furthermore, Medicare’s general fund is projected to continue to grow and put increasing pressure on the rest of the federal budget.
  6. The general fund is the largest source of financing for Medicare


Without reform, Medicare spending will continue to rise over the coming years — threatening the HI Trust Fund and placing immense pressure on the overall federal budget. Fortunately, there are many solutions available to put the program on sound financial footing. Policymakers could increase revenues dedicated to the program, reduce program expenditures, or some combination of both. Securing that trust fund would not only prevent payment cuts to beneficiaries, but also help relieve pressure on the nation’s unsustainable fiscal outlook.

Related: Social Security Faces Serious Financial Shortfalls, And Other Takeaways From The Trustees Report

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