State Health Care Spending Growth Trends Point to Need for Policy Action

Health Affairs Forefront published the third annual analysis of spending growth trends across cost growth target states on August 23, 2025. The analysis of 2023 health care spending trends in five cost growth target states, by Jessica Mar and January Angeles of Bailit Health, finds that Connecticut, Delaware, Massachusetts, Oregon, and Rhode Island exceeded their targets. Spending was high in all service categories, and in most states, Medicare or Medicaid spending grew faster than in previous years.

“As these states consider shifting their affordability strategies from transparency and monitoring toward action, it will be essential for state legislatures to equip agencies with robust enforcement authority to hold health care providers, insurers, and other entities accountable for exceeding targets and complementary cost containment policies,” the authors say. Complementary policies may include site-neutral payment policies, price growth caps, prescription drug price and pharmacy benefit manager oversight, and delivery system reforms.