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Debt Digest | Federal Debt is a Health Care Problem
Welcome David Ditch to the Debt Dispatch! We are pleased to announce a new regular contributor: David Ditch will be joining the Cato Institute as a Policy Analyst for Budget and Entitlement Policy later this week. David has more than a decade of experience in fiscal policy issues, with a particular focus on federal spending. He previously worked at the Senate Budget Committee, the Heritage Foundation, and the Economic Policy Innovation Center. David’s areas of expertise include appropriations, transportation, agriculture, federalism, grantmaking, and policy options for deficit reduction. Originally from the Rochester, N.Y. area, David has a BA in Economics and Political Science from the University of Rochester and a MA in Political Management from George Washington University. David currently lives in Arlington, VA. You may have enjoyed his earlier guest posts: CBO: New Highway Bill Has More Spending, Taxes, and Deficits Trump Administration’s Proposed Changes to Federal Grants Highlight Problems of Big Government Here are this week’s reading links and fiscal facts: The federal debt is largely a health care problem. In a new report, the Congressional Budget Office and Joint Committee on Taxation find that “In 2026, federal subsidies for health insurance, net of related payments to the government, are projected to equal $2.4 trillion, or 7.4 percent of gross domestic product (GDP). In CBO and JCT’s projections, those subsidies grow by 65 percent, reaching $3.9 trillion, or 8.4 percent of GDP, in 2036. Subsidies for Medicare contribute most to that overall growth, increasing by $900 billion. Over the entire 2026–2036 period, federal subsidies for health insurance total $33.6 trillion.” Cato’s Michael Cannon emphasizes, “The long-term federal debt problem is a health care problem. […] Only two categories of federal outlays will grow faster than gross domestic product (GDP): health care subsidies and interest payments on the debt. The former is, therefore, the primary driver of the latter.” The bond market fears deficits, not the loss of tariff revenue. Responding to a New York Times essay claiming tariff revenue has grown too important for a future administration to unwind, Cato’s Kyle Handley argues: “Bond investors are not attached to customs duties as a line item revenue source. They care about the government’s overall fiscal position.” He continues, “tariff revenue is a side hustle. And the Trump administration has already promised to dole out the funds through schemes like tariff dividend rebates, farm subsidies, and pay-fors on tax cuts or other spending.” Furthermore, “tariff revenue is simply not large enough to transform the government’s fiscal trajectory.” Take net interest for example: it “reached $970 billion in fiscal year 2025, absorbing 18.5 percent of federal receipts. Customs duties accounted for only 3.7 percent of receipts—and that was before refunds (see Figure 2).” Handley concludes, “The real bond-market concern is a large and growing interest bill, persistent budget deficits, and a political system unwilling to bring spending and revenue into alignment.” Medicare’s spending growth is driven by more volume and utilization. A Congressional Research Service report finds that Medicare spending “grew at an average annual rate of 7.3%” from 1985 through 2025, and the trustees project health care expenditures will keep rising “faster than gross domestic product (GDP) in most future years.” Citing CBO, the report attributes Medicare’s projected 2026–2036 spending growth to “23% from higher enrollment, 31% from inflation, and 47% from the growth of inflation-adjusted spending per beneficiary. In other words**, the largest single driver of Medicare spending growth during the next decade is expected to be higher volume and intensity of health care services.”** Boccia and Thakur explain: “as the economy grows, Medicare spending tends to grow at least as fast—and often faster—because the program automatically pays the bill for more and more healthcare consumption by seniors, even as prices rise.” The Fed has little control over market interest rates. Cato’s Jai Kedia documents that the Fed has held its rate target steady since December, yet “nearly every rate Americans actually borrow at has climbed over the same stretch.” Kedia continues, “The Fed did nothing, and the cost of credit went up anyway. […] Markets spent these months repricing macroeconomic events such as sticky core inflation, a volatile energy market driven by the conflict in the Middle East, and global trade disrupted by tariffs, among others. None of that required a policy change to show up in borrowing costs because markets, not the FOMC, set prices.” He concludes, “Accurately priced borrowing rates will come from credible disinflation and disciplined budgets and from a Fed content to follow the economy rather than pretend it leads it.” Nearly half of US farm income comes from taxpayers. Former Reagan OMB director David Stockman notes that “in the most recently completed full year (FY 2025) farmer incomes in the US totaled $97.8 billion, but fully 42.7% or $41.8 billion of that amount came from taxpayers, not the marketplace. Nor is this some kind of one-year aberration. If we look at the most recent decade as a whole, total farm income posted at nearly $708 billion, but, as indicated, fully $322 billion or 45% of this came compliments of US taxpayers.” Cato’s Chris Edwards explains why so little of that income is market-earned: “Farmers are businesspeople, but the government shields them from just about every type of weather and market risk. Furthermore, just about every part of the agricultural industry is subsidized, including insurance, loans, marketing, research, export sales, and land improvements.” The Debt Dispatch is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
Cathie Wood says battered SpaceX could become 'most important company in global history'
ARK Invest allocated $80 million to SpaceX after its IPO, and CEO Cathie Wood remains bullish even as the stock sheds nearly $1.4 trillion in market value.
What’s in Trump’s $3.4 Trillion Tax and Spending Bill: 2025 Reconciliation Act
The Senate passed the Protect College Sports Act (S. 4668). Here's what the federal NIL bill means for revenue sharing, transfers, and state NIL laws.
Roundup: LNG exports / Prairieville market / GLP-1 rivalry
Predicted to double: U.S. LNG exports are expected to nearly double by 2031, becoming the country’s second-largest net export industry and contributing an estimated $1.4 trillion to the economy. The growth is driven by abundant shale gas supplies, major Gulf Coast investments and rising global demand, with LNG exports projected to support hundreds of thousands […]
The Federal Government’s $33.6 Trillion Health Care Problem
The Congressional Budget Office’s (CBO) latest report on federal health-insurance subsidies estimates the federal government will subsidize health coverage by approximately $2.4 trillion in 2026, by $3.9 trillion by 2036, and by a total of $33.6 trillion over the intervening decade. For all the focus on health care costs in the United States, CBO’s new […]
The $124 trillion Great Wealth Transfer is more than just cash: More U.S. businesses are now being inherited than bought, BofA finds
A greater share of companies passed down to family members could be a sign of greater wealth concentration and the power of private markets.
Scientists Propose ‘StormWall’ To Stop A $2.4 Trillion Solar Storm
A proposed StormWall spacecraft fleet could release gas to weaken solar storms, protecting satellites, power grids and technology, but potentially reducing auroras.
EPA sued for attacks on science & clean air which hike your energy costs $1.4T
17 groups filed suit against EPA's attacks on the public which will raise energy costs by $1.4 trillion - and trillions more in health costs.
United Nations: business can’t build economic resilience from the sidelines
As geopolitical risk rises and the $4 trillion SDG financing gap widens, blended finance will only scale if companies help design systems.
H.R. 1 underscores unfairness in Colorado tax code
By Caroline Nutter On July 4, 2025, Colorado’s budget was overturned with the stroke of a pen. When President Donald Trump signed into law H.R. 1, or the One Big Beautiful Bill Act, he didn’t only cut federal funding by $3.4 trillion, he also cut Colorado’s budget by more than $1 billion. H.R. 1 expanded […]
Southern Taiwan Science Park revenue climbs 36.5% in first eight months of 2026
Companies in the Southern Taiwan Science Park (STSP) posted record revenue of NT$2.495124 trillion (US$78.59 billion) in the first eight months of 2026, up 36.5% from a year earlier, according to the STSP Bureau. The bureau said the growth reflected the global AI boom and the park's expanding role in the high-tech supply chain.
Russian Business Leaders Ask Putin to Ease Wave of Nationalizations
Russian business leaders have appealed to President Vladimir Putin to rein in a wave of state asset seizures that has affected factories, ports and major corporations worth more than 4 trillion rubles ($43 billion), the Kommersant business daily reported.
Four states seeking $1.4 trillion in penalties in child social media addiction trial, Meta says
Four states are seeking $1.4 trillion from Meta over claims Facebook and Instagram were designed to be addictive to children without any warnings on the alleged harms of the apps.
Robinhood Now Has 13 Separate Business Lines Above $100 Million in Annualized Revenue. Here's Why Crypto No Longer Decides the Quarter.
The company is expanding to capture its share of a $84 trillion opportunity in the next 20 years.
Tim Cook proved Silicon Valley wrong about founders
Tim Cook defied Silicon Valley's founder myth, turning Apple into a $4 trillion giant and proving non-founders can build lasting value
Global entertainment and media advertising revenues to hit US$1.4 trillion in 2030 - as global box office continues recovery: PwC
The global entertainment and media (E&M) industry will hit US$4.2 trillion in revenues in 2030, growing at a CAGR of 3.4%, as AI-powered advertising and in-person, live experiences power growth in the industry, according to PwC's Global Entertainment & Media Outlook 2026-30, released today.
Global entertainment and media advertising revenues to hit US$1.4 trillion in 2030 – as global box office continues recovery: PwC
The global entertainment and media (E&M) industry will hit US$4.2 trillion in revenues in 2030, growing at a CAGR of 3.4%, as AI-powered advertising and in-person, live experiences power growth in the industry, according to PwC’s Global Entertainment & Media Outlook 2026-30, released today.
Why the Wellness Industry Is Betting Big on Longevity Science: Expert View by Spherical Insights
Wellness market is projected to grow from approximately USD 5.4 trillion in 2024 to nearly USD 10.73 trillion by 2035, registering a CAGR of around 6.44% during 2025–2035.
ChatGPT is getting ads
The move comes as OpenAI looks to increase its revenue amid $1.4 trillion in spending commitments and a possible IPO.