Out-of-pocket (OOP) costs have declined as a share of overall health spending but their burden on households has remained steady: Out-of-pocket spending as a share of total health spending and as a share of bottom 90 percent household income, 1960–2014
| OOP costs as share of bottom 90% household incomes | OOP costs as share of total health costs | |
|---|---|---|
| 1961 | 5.247% | 45.840% |
| 1962 | 5.338% | 44.768% |
| 1963 | 5.446% | 44.258% |
| 1964 | 5.725% | 44.090% |
| 1965 | 5.726% | 43.508% |
| 1966 | 5.364% | 40.351% |
| 1967 | 4.936% | 35.949% |
| 1968 | 4.965% | 35.102% |
| 1969 | 4.922% | 34.284% |
| 1970 | 4.934% | 33.466% |
| 1971 | 4.799% | 31.805% |
| 1972 | 4.821% | 30.916% |
| 1973 | 4.723% | 30.761% |
| 1974 | 4.365% | 29.493% |
| 1975 | 4.345% | 27.957% |
| 1976 | 4.386% | 26.612% |
| 1977 | 4.353% | 25.800% |
| 1978 | 4.154% | 24.582% |
| 1979 | 3.953% | 23.614% |
| 1980 | 3.895% | 22.773% |
| 1981 | 3.948% | 22.068% |
| 1982 | 4.034% | 21.689% |
| 1983 | 4.190% | 21.375% |
| 1984 | 4.211% | 21.358% |
| 1985 | 4.391% | 21.594% |
| 1986 | 4.439% | 21.827% |
| 1987 | 4.543% | 21.229% |
| 1988 | 4.651% | 20.753% |
| 1989 | 4.514% | 19.643% |
| 1990 | 4.641% | 19.113% |
| 1991 | 4.562% | 17.869% |
| 1992 | 4.376% | 16.764% |
| 1993 | 4.212% | 15.721% |
| 1994 | 4.026% | 14.685% |
| 1995 | 3.821% | 14.175% |
| 1996 | 3.778% | 13.994% |
| 1997 | 3.861% | 14.215% |
| 1998 | 3.963% | 14.717% |
| 1999 | 3.948% | 14.681% |
| 2000 | 4.007% | 14.527% |
| 2001 | 3.937% | 13.875% |
| 2002 | 4.139% | 13.464% |
| 2003 | 4.221% | 13.331% |
| 2004 | 4.195% | 13.108% |
| 2005 | 4.236% | 13.036% |
| 2006 | 4.131% | 12.673% |
| 2007 | 4.102% | 12.634% |
| 2008 | 4.061% | 12.304% |
| 2009 | 4.050% | 11.771% |
| 2010 | 4.074% | 11.534% |
| 2011 | 4.079% | 11.526% |
| 2012 | 4.070% | 11.380% |
| 2013 | 4.038% | 11.295% |
| 2014 | 3.923% | 10.907% |
Notes: Exact data are unavailable for years prior to 1979, so we assumed that household incomes rose at the same rate as per capita personal income from BEA 2018, NIPA Table 2.1. For OOP costs as a share of income for the bottom 90 percent of households, we allocate 90 percent of total out-of-pocket costs to the bottom 90 percent of households in each year.
Sources: Data on out-of-pocket costs and overall costs come from CMS 2018. Data on total income for the bottom 90 percent of households come from CBO 2018a.