Spending · category

Medicare

Health insurance for people 65 and older and for people with disabilities. In FY2025 it came to $997B, 14.2% of all federal spending (#2 of 18 categories). Adjusted for inflation, that is up 186% since FY2000.

$997B

FY2025 outlays

14.2%

of all federal spending

+14%

change from FY2024 ($874B)

99%

mandatory (the rest is discretionary)

Every program

6 accounts with FY2025 spending in Medicare, largest first. Hover or tap a bar for details.

Mandatory (set by standing law)Discretionary (set by yearly appropriations)

Medicare Part B: doctors & outpatient careFederal Supplementary Medical Insurance Trust Fund · Centers for Medicare and Medicaid Services

$579B

Medicare Part A: hospital insuranceFederal Hospital Insurance Trust Fund · Centers for Medicare and Medicaid Services

$445B

Medicare Part D: prescription drugsMedicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund · Centers for Medicare and Medicaid Services

$163B

Health Care Fraud and Abuse Control AccountCenters for Medicare and Medicaid Services

$2.63B

Medicare Payment Advisory CommissionLegislative Branch Boards and Commissions

$1M

Quality Improvement OrganizationsCenters for Medicare and Medicaid Services

$1M

How the total adds up

Programs (the 6 accounts above)	$1.19T
Offsets: premiums, fees, loan repayments, and other collections (19 accounts)	−$235B
Payments between government accounts, net (e.g. general-fund transfers into trust funds, less the matching receipts)	$42.7B
Net outlays, matching OMB Historical Table 3.2	$997B

The largest offsets

Premiums Collected for the Aged, FSMI Fund Department of Health and Human Services	−$133B
FHI Trust Fund, Taxation on OASDI Benefits Centers for Medicare and Medicaid Services	−$41.1B
Payments from States, Medicare Prescription Drug Account, FSMI Department of Health and Human Services	−$18.6B
Premiums Collected for the Disabled, FSMI Fund Department of Health and Human Services	−$14.6B
FHI Trust Fund, Medicare Refunds Department of Health and Human Services	−$8.56B
Premiums Collected for Medicare Prescription Drug Account, FSMI Department of Health and Human Services	−$6.20B
FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible Department of Health and Human Services	−$5.48B
Medicare Refunds, SMI Department of Health and Human Services	−$4.07B
FHI Trust Fund, Payments from the General Fund (uninsured and Program Management) Centers for Medicare and Medicaid Services	−$954M
Affordable Care Act Medicare Shared Savings Models, SMI Department of Health and Human Services	−$616M
Affordable Care Act Medicare Shared Savings Models (HI) Department of Health and Human Services	−$504M
Basic Premium, Medicare Advantage, FSMI Trust Fund Department of Health and Human Services	−$378M

All programs, sortable

Sparklines show each program in 2025 dollars, FY2000–2025.

Program	Type	FY2024	FY2025	Change
Medicare Part B: doctors & outpatient care Centers for Medicare and Medicaid Services	Mandatory	$526B	$579B	+10%
Medicare Part A: hospital insurance Centers for Medicare and Medicaid Services	Mandatory	$407B	$445B	+9.2%
Medicare Part D: prescription drugs Centers for Medicare and Medicaid Services	Mandatory	$117B	$163B	+39%
Health Care Fraud and Abuse Control Account Centers for Medicare and Medicaid Services	Mandatory	$2.65B	$2.63B	−0.6%
Medicare Payment Advisory Commission Legislative Branch Boards and Commissions	Discretionary	$0	$1M	n/a
Quality Improvement Organizations Centers for Medicare and Medicaid Services	Mandatory	$21M	$1M	−95%

Medicare since 1993

Outlays in 2025 dollars (adjusted for inflation), fiscal years 1993–2025. Share of all federal spending: 9.3% in FY1993, 14.2% in FY2025.

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