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Data: Centers for Medicare & Medicaid Services' Office of the Actuary; Chart: Axios Visuals

Americans spent $3.65 trillion on health care in 2018 — 4.6% more than the year before. That growth also was higher than the 4.2% rate from 2017, according to revised figures from independent federal actuaries.

Between the lines: U.S. health care spending climbed again not because people went to the doctor or hospital more frequently, but because the industry charged higher prices. And private health insurers didn't do a particularly good job negotiating lower rates.

The intrigue: The number of people with private health plans — which mostly consists of the coverage people get through their jobs — dipped in 2018, yet the amount spent per person soared 6.7%.

  • That is the highest per-enrollee spending growth rate among people with private health insurance since 2004, actuaries wrote.
  • Part of that increase was due to higher premiums that insurance companies passed on from the Affordable Care Act's health insurance tax.
  • More importantly: Hospitals, doctors and drugmakers continued to wring out much higher rates from private insurers thanks to provider mergers and perverse negotiating incentives.

Medicare and Medicaid had much lower per-enrollee spending growth rates in 2018 than private insurance, but those figures were the highest they've been since 2015 — again due to higher costs for the private insurers that are increasingly running those government programs.

Go deeper: Democrats double down on health care prices

Go deeper

Updated 27 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 11 p.m. ET: 19,511,596 — Total deaths: 724,590 — Total recoveries — 11,876,387Map.
  2. U.S.: Total confirmed cases as of 11 p.m. ET: 4,995,369 — Total deaths: 162,461 — Total recoveries: 1,643,118 — Total tests: 61,080,587Map.
  3. Politics: Trump signs 4 executive actions on coronavirus aid — Democrats slam Trump, urge GOP to return to negotiations
  4. Public health: Fauci says chances are "not great" that COVID-19 vaccine will be 98% effective — 1 in 3 Americans would decline COVID-19 vaccine.
  5. Science: Indoor air is the next coronavirus frontline.
  6. Schools: How back-to-school is playing out in the South as coronavirus rages on — Princeton, Johns Hopkins, Howard to hold fall classes online.

Trump signs 4 executive actions on coronavirus aid

President Trump speaking during a press conference on Aug. 8. Photo: Jim Watson/AFP via Getty Images

President Trump on Saturday signed four executive actions to provide relief from economic damage sustained during the coronavirus pandemic after talks between the White House and Democratic leadership collapsed Friday afternoon.

Why it matters: Because the Constitution gives Congress the power to appropriate federal spending, Trump has limited authority to act unilaterally — and risks a legal challenge if congressional Democrats believe he has overstepped.

10 hours ago - World

What's next for Lebanon after the Beirut explosion

Photo: Houssam Shbaro/Anadolu Agency via Getty Images

Beirut residents are still clearing rubble from streets that appear war-torn, days after a blast that shocked the country and horrified the world.

Why it matters: The explosion is likely to accelerate a painful cycle Lebanon was already living through — discontent, economic distress, and emigration.