Supplementary Data Tables Trends in the Overall Health Care Market APPENDIX 1

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market Year Total National Health Expenditures Prescription Drugs Total TotalPer Capita Nominal Dollars (billions) Real Dollars (2) (billions) Nominal DollarsReal Dollars (2) Nominal Dollars (billions) Real Dollars (2) (billions) 1980$255.3 $1,110 $ $296.2$268.5 $1,271 $1,152$13.4$ $334.0$285.2 $1,421 $1,214$15.0$ $367.8$304.3 $1,552 $1,284$17.3$ $405.0$321.2 $1,695 $1,344$19.6$ $442.9$339.2 $1,830 $1,402$21.8$ $474.7$356.9 $1,945 $1,463$24.3$ $516.5$374.7 $2,100 $1,523$26.9$ $579.3$403.5 $2,336 $1,627$30.6$ $644.8$428.5 $2,569 $1,707$34.8$ $721.4$454.8 $2,840 $1,791$40.3$ $788.1$476.8 $3,066 $1,855$44.4$ $854.1$501.6 $3,285 $1,929$47.0$ $916.6$522.7 $3,485 $1,987$49.6$ $967.2$537.8 $3,636 $2,022$53.0$ $1,021.6$552.4 $3,812 $2,061$59.8$ $1,074.4$564.3 $3,965 $2,082$68.1$ $1,135.5$583.0 $4,144 $2,128$77.6$ $1,202.0$607.6 $4,339 $2,194$88.5$ $1,278.3$632.2 $4,582 $2,266$104.6$ $1,369.7$655.4 $4,857 $2,324$121.0$ $1,486.7$691.7 $5,217 $2,427$139.0$ $1,629.2$746.2 $5,677 $2,600$157.9$ $1,768.2$791.8 $6,097 $2,731$176.7$ $1,896.5$827.3 $6,473 $2,823$192.8$ $2,024.5$854.2 $6,863 $2,896$205.1$ $2,157.0$881.6 $7,238 $2,958$224.1$ $2,296.2$912.5 $7,628 $3,032$235.6$ $2,402.6$919.5 $7,903 $3,025$241.4$ $2,496.4$958.8 $8,158 $3,133$252.7$ $2,595.7$980.9 $8,400 $3,174$253.0$ $2,696.6$987.8 $8,671 $3,176$258.7$ $2,799.0$1,004.5 $8,914 $3,199$259.1$ $2,879.9$1,018.7 $9,114 $3,224$265.3$ $3,031.3$1,055.1 $9,532 $3,318$297.7$103.6 A-4 Table 1.1: Total National Health Expenditures, 1980 – 2014 (1) Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released December 3, (1) CMS completed a benchmark revision in 2009, introducing changes in methods, definitions and source data that are applied to the entire time series (back to 1960). For more information on this revision, see Expressed in 1980 dollars; adjusted using the overall Consumer Price Index for Urban Consumers. Data for Charts 1.1, 1.3 and 1.10

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market A-5 Table 1.2: Percent Change in National Expenditures for Selected Health Services and Supplies, 2004 – 2014 (1) Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released December 3, (1) CMS completed a benchmark revision in 2009, introducing changes in methods, definitions and source data that are applied to the entire time series (back to 1960). For more information on this revision, see Data for Chart 1.7 YearHospital Care Prescription Drugs Admin. & Net Cost of Private Health InsuranceHome Health Care Nursing Home Care %9.2%7.2%11.1%5.2% %6.4% 10.5%6.3% %9.2%9.8%5.5%4.3% %5.2%4.0%10.4%8.1% %2.5%-2.0%8.4%4.1% %4.7%-1.0%8.1%4.1% %0.1%9.5%5.5%2.9% %2.2%5.0%3.6%4.2% %0.2%2.7%4.4%1.0% %2.4%5.8%3.3%1.3% %12.2%12.1%4.8%3.6%

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market A-6 Table 1.3: National Health Expenditures, (1) 1980 – 2024 (2) Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released September (1) Years 2014 – 2023 are projections. (2) CMS completed a benchmark revision in 2009, introducing changes in methods, definitions and source data that are applied to the entire time series (back to 1960). For more information on this revision, see Data for Chart 1.8 YearExpenditures (billions) 1980 $ $ $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $3, $3, $3, $3, $3, $4, $4, $4, $4, $5, $5,425.1

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market A-7 Table 1.4: Consumer Out-of-pocket Payments for National Health Expenditures, 1994 – 2014 (1) Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released December 3, (1) CMS completed a benchmark revision in 2009, introducing changes in methods, definitions and source data that are applied to the entire time series (back to 1960). For more information on this revision, see Data for Chart 1.9 Year Payment (billions) 1994 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $329.8

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market Table 1.5: Growth in Total Prescription Drug Spending as a Percentage of Total Growth in National Health Expenditures, 1994 – 2014 (1) Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released December 3, (1) CMS completed a benchmark revision in 2009, introducing changes in methods, definitions and source data that are applied to the entire time series (back to 1960). For more information on this revision, see Data for Chart 1.11 YearPercentage % % % % % % % % % % % % % % % % % % % % % A-8

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market A-9 Table 1.6: Consumer Out-of-pocket Spending vs. Private Health Insurance Spending for Prescription Drugs, 1994 – 2014 (1) Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released December 3, (1) CMS completed a benchmark revision in 2009, introducing changes in methods, definitions and source data that are applied to the entire time series (back to 1960). For more information on this revision, see Data for Chart 1.12 Year Out-of-pocket Payment (billions) Private Health Insurance (billions) 1994$23.176$ $23.201$ $24.241$ $25.709$ $27.519$ $30.481$ $33.648$ $36.350$ $40.807$ $45.466$ $48.145$ $51.326$ $51.213$ $52.160$ $49.621$ $49.060$ $45.251$ $45.452$ $45.221$ $43.547$ $44.722$

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market A-10 Table 1.7: Number and Percent Uninsured, 1994 – 2014 Source: US Census Bureau, Health Insurance Coverage in the United States: Data released September Figure 1. Uninsured Rate: 2008 to Data for Chart 1.15 YearNumber (millions)Percent % % % % % % % % % % % % % % % % % % % % %

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market A-11 Table 1.8: Average Percent Uninsured by State, 2013 – 2014 Source: US Census Bureau, Health Insurance in the United States: Data released September Link: Data for Chart 1.16 State Average Percent UninsuredState Average Percent Uninsured Alabama12.9Montana15.3 Alaska17.8Nebraska10.5 Arizona15.4Nevada17.9 Arkansas13.9New Hampshire9.9 California14.8New Jersey12.1 Colorado12.2New Mexico16.6 Connecticut8.2New York9.7 Delaware8.5North Carolina14.4 District of Columbia5.9North Dakota9.1 Florida18.3Ohio9.7 Georgia17.3Oklahoma16.5 Hawaii6.0Oregon12.2 Idaho14.9Pennsylvania9.1 Illinois11.2Rhode Island9.5 Indiana12.9South Carolina14.7 Iowa7.2South Dakota10.5 Kansas11.2Tennessee12.9 Kentucky11.4Texas20.6 Louisiana15.7Utah13.3 Maine10.7Vermont6.1 Maryland9.0Virginia11.6 Massachusetts3.5Washington11.6 Michigan9.7West Virginia11.3 Minnesota7.0Wisconsin8.2 Mississippi15.8Wyoming12.7 Missouri12.3

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market Year Aged (millions) Blind/ Disabled (millions) Children (millions) Adults (millions) Other Title XIX (2) (millions) Total (millions) A-12 Table 1.9: Medicaid Enrollees, (1) 1990, 1995, 2000 – 2016 Source: Congressional Budget Office. Data released March Detail of Spending and Enrollment for CBO’s March 2016 Baseline: Medicaid. Link: (1) Does not include CHIP enrollees. (2) In 1997, the Other Title XIX category was dropped and the enrollees therein were subsumed in the remaining categories. Other Title XIX enrollees referred to others who received Medicaid benefits. (3) For 2014 onward, CBO changed from reporting annual enrollment to average monthly enrollment. Therefore, category values are derived from the total ever enrolled. (4) Parts may not sum to total due to rounding. Data for Chart 1.18 (4) (3)

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market A-13 Table 1.10: Percent Change in CHIP Enrollment by State, FY 2013 – FY 2014 Source: Centers for Medicare & Medicaid Services. Data released July Number of Children Ever Enrolled by Program Type. Link: Data for Chart 1.20 State Percent Change FY 13 - FY 14State Percent Change FY 13 - FY 14 Alabama-7.0%Montana11.2% Alaska-41.7%Nebraska1.2% Arizona-32.3%Nevada60.2% Arkansas-8.4%New Hampshire-10.2% California-2.0%New Jersey2.2% Colorado38.8%New Mexico71.2% Connecticut4.9%New York-10.0% Delaware41.5%North Carolina-9.2% District of Columbia-21.8%North Dakota-55.4% Florida-10.4%Ohio-29.8% Georgia-14.3%Oklahoma11.4% Hawaii-1.5%Oregon-14.8% Idaho-1.1%Pennsylvania-3.2% Illinois-3.6%Rhode Island-16.7% Indiana0.7%South Carolina4.7% Iowa-0.3%South Dakota-10.0% Kansas-3.4%Tennessee6.0% Kentucky-26.9%Texas0.7% Louisiana-9.1%Utah21.5% Maine-7.6%Vermont-19.5% Maryland1.3%Virginia-5.3% Massachusetts-15.0%Washington-3.3% Michigan16.1%West Virginia10.2% Minnesota-6.4%Wisconsin4.5% Mississippi-13.5%Wyoming3.2% Missouri-6.6%

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market A-14 Table 1.11: Percentage of Employees with Employer-based Coverage Who Can Choose Conventional, PPO, HMO, POS, and HDHP/SO Plans, 1988 – 2015 Table 1.12: Percent Distribution of Employer-sponsored Health Insurance Enrollment by Type of Plan, 1988 – 2015 Source: The Kaiser Family Foundation and Health Research and Educational Trust. Data released Employer Health Benefits: 1999, 2002, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 and Link: four-types-of-plans-offered/. KPMG Survey of Employer-Sponsored Health Benefits: 1988, HMO: Health Maintenance Organization; PPO: Preferred Provider Organization. (1) Conventional plans refer to traditional indemnity plans. (2) Point-of-service plans not separately identified in (3) In 2006, the survey began asking about HDHP/SO, high deductible health plans with a savings option. Data for Chart 1.21 Source: The Kaiser Family Foundation and Health Research and Educational Trust. Data released Employer Health Benefits: 1999, 2002, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 and Link: five-market-shares-of-health-plans/. KPMG Survey of Employer-Sponsored Health Benefits: 1988, (1) Conventional plans refer to traditional indemnity plans. (2) Point-of-service plans not separately identified in (3) In 2006, the survey began asking about HDHP/SO, high-deductible health plans with a savings option. (4) Totals may not sum to 100 percent due to rounding. Data for Chart Conventional (1) 90%52%26%14%10% 8%5%6%7%4% 3%2% PPO18%45%62%74%79% 77%80%79%76%75%76%77%72% HMO46%64%56%50%43%42%41%44%42%39%37%34%31%32% POS (2) 30%45%34%23%21%24%19%14%16%14%13% 16% HDHP/SO (3) 14%18%25%28%32%40%39%43%45%51% Conventional (1) 73%27%10%4%3% 2%1% <1% 1% PPO11%28%39%52%60%57%58%60%58%55%56%57%58%52% HMO16%31%28%27%20%21%20% 19%17%16%14%13%14% POS (2) 14%24%18%13% 12%10%8%10%9% 8%10% HDHP/SO (3) 4%5%8% 13%17%19%20% 24%

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market A-15 Table 1.13: Growth in Medicare Spending per Beneficiary vs. Private Health Insurance Spending per Enrollee, 1994 – 2014 (1,2,3) Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released December 3, (1) CMS completed a benchmark revision in 2009, introducing changes in methods, definitions and source data that are applied to the entire time series (back to 1960). For more information on this revision, see (2) Data reflects spending on benefits commonly covered by Medicare and Private Health Insurance. (3) CMS no longer includes the National Health Expenditure (NHE) table used to calculate growth in Medicare spending from Data for 2014 reflects calculations using current NHE tables as recommended by CMS in correspondence. Data for Chart 1.24 Year Growth in Medicare Spending per Beneficiary Growth in Private Health Insurance Spending per Enrollee %1.7% %1.6% %1.6% %3.3% %4.8% %4.4% %6.1% %8.8% %9.3% %9.8% %8.1% %6.7% %6.4% %5.2% %6.3% %7.3% %4.9% %4.6% %5.5% %2.9% %0.1%

TRENDWATCH CHARTBOOK 2016 Supplementary Data Tables, Trends in the Overall Health Care Market A-16 Table 1.14: Percentage of Medicaid Beneficiaries Enrolled in Medicaid Managed Care by State, 2011 and 2013 Sources: 1. Centers for Medicare & Medicaid Services, Office of the Actuary. Medicaid Managed Care Enrollment Report as of June 30, 2010 and July 1, Link: systems/medicaid-managed-care/medicaid-managed-care-enrollment-report.html. 2. The Kaiser Family Foundation. State Health Facts. Total Medicaid Managed Care Enrollment. Link: Data for Chart 1.26 State % Enrolled State % Enrolled Alabama61.1%59.5%Montana76.1%65.5% Alaska0.0% Nebraska85.1%75.7% Arizona88.7%84.4%Nevada83.6%54.9% Arkansas78.4%77.7%New Hampshire0.0% California60.1%67.4%New Jersey77.7%87.9% Colorado94.6%95.3%New Mexico72.8%74.5% Connecticut68.6%0.00%New York76.7%75.5% Delaware80.5%84.4%North Carolina83.2%76.1% District of Columbia67.4%67.7%North Dakota63.6%55.7% Florida63.8%62.8%Ohio75.4%69.8% Georgia91.3%65.4%Oklahoma86.5%73.4% Hawaii98.7% Oregon98.2%90.2% Idaho100.0%94.6%Pennsylvania81.5%54.0% Illinois67.8%70.5%Rhode Island68.6%74.9% Indiana70.3%68.0%South Carolina100.0%63.8% Iowa91.1%82.2%South Dakota75.8%74.8% Kansas87.4%82.5%Tennessee100.0% Kentucky89.4%84.6%Texas70.7%77.3% Louisiana65.3%87.6%Utah99.8%98.5% Maine49.3%61.5%Vermont58.5%56.5% Maryland74.6%79.4%Virginia58.2%67.8% Massachusetts53.1%64.1%Washington88.1%67.3% Michigan88.4%71.1%West Virginia51.0%52.8% Minnesota65.7%70.2%Wisconsin63.7%62.8% Mississippi87.2%77.5%Wyoming0.0% Missouri97.7%97.2%Nation74.2%71.7%

TRENDWATCH CHARTBOOK 2016 Source: YCharts data used for 2014 and Data from FactSet Research Systems Inc. used in 2012, 2013, and earlier years’ Chartbooks. (1) Wellpoint in 2014 and earlier years’ Chartbooks. In December 2014, Wellpoint changed its name to Anthem. Data for Chart 1.31 Supplementary Data Tables, Trends in the Overall Health Care Market A-17 Table 1.15: Operating Margins of the Top Insurers, 2013 – Aetna 6.7%7.3%8.1% Anthem (1) 8.0%5.9% United HealthCare 7.9% 7.0% Cigna 6.7%9.5%8.8% Humana 5.0%4.5%

TRENDWATCH CHARTBOOK 2016