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One Federal Department Now Spending $100 Billion Per Month

The opinions expressed by columnists are their own and do not necessarily represent the views of

For the first time in our nation's history, there is now a federal department spending an average of more than $100 billion per month.

No, it is not the Department of Defense, which is charged with the core federal responsibility of defending us from foreign enemies.


It is the Department of Health and Human Services, which, if Democratic Sen. Bernie Sanders of Vermont has his way, will run the "Medicare for All" program.

As it now stands, HHS runs Medicare for many and Medicaid for more.

"In 2019, the program will cover an estimated 61 million persons (52 million aged and 9 million disabled)," the Congressional Research Service said of Medicare in a report published in May.

"Medicaid is a means-tested entitlement program that finances the delivery of primary and acute medical services as well as long-term services and supports (LTSS) to an estimated 75 million people at a cost to states and the federal government of $616 billion in FY2018," CRS said in a report published in June.

"CBO also estimates that federal Medicare spending (after deduction of beneficiary premiums and other offsetting receipts) will be about $637 billion in 2019, accounting for about 14% of total federal spending and 3% of GDP," said CRS.

"Mandatory spending typically accounts for the majority of the HHS budget," CRS explained in a report published in March.

"Two programs -- Medicare and Medicaid -- are expected to account for 86% of all estimated HHS spending in FY2019," it said.

In the first eight months of this fiscal year, which began in October, HHS spent $834,346,000,000, according to the Monthly Treasury Statement for May. That is up from $731,724,000,000 in the first eight months of last fiscal year.


Through all of fiscal 2018, HHS spent approximately $1,120,500,000,000 -- or $93,375,000,000 per month.

Through this full fiscal year, according to the estimate published in the Monthly Treasury Statement, HHS will spend approximately $1,230,273,000,000 -- or $102,522,750,000 per month.

In May alone, according to the Monthly Treasury Statement, HHS spent $146,552,000,000.

That equaled about $4.9 billion per day, or $196.98 million per hour, or $3.28 million per minute.

In the same month, the Department of Defense and military programs were spending $61,801,000,000 -- or about 42.17 percent of what HHS was spending that month. In the first eight months of the fiscal year, the DOD and military programs spent $439,289,000,00 -- or about 52.65 percent of the $834,346,000,000 billion that HHS spent.

The Monthly Treasury Statement estimates that the DOD and military programs will spend a total of approximately $652,234,000,000 this fiscal year -- or about 53 percent of the $1,230,273,000,000 it estimates HHS will spend.

Most other departments of the federal government spend just a small fraction of what HHS spends.

The Department of Homeland Security, which is charged with securing our borders and enforcing our immigration laws, will spend an estimated $62,267,000,000 -- or just 5.06 percent of the $1.23 trillion HHS will spend.


The Department of Justice, which is charged with enforcing federal laws, will spend an estimated $41,366,000,000 -- or just 3.36 percent of what HHS will spend.

The Department of State, which manages U.S. relations with foreign nations, will spend an estimated $29,690,000,000 -- or just 2.41 percent of what HHS will spend.

The legislative branch, which makes the laws, will spend an estimated $5,826,000,000 -- or just 0.47 percent of what HHS will spend.

Only one other federal agency or department rivals HHS for spending money. It is the Social Security Administration.

It is the federal government's other trillion-dollar baby.

In fiscal 2019, according to the estimate published in the Monthly Treasury Statement, it will spend $1,104,449,000,000. In the first eight months of this fiscal year, it spent $730,000,000,000 -- or an average of $91,250,000,000 per month.

In fiscal 2018, according to the Monthly Treasury Statement for September 2018, the Social Security Administration spent $1,039,902,000,000 while HHS was spending $1,120,500,000,000.

Those two elements of the federal government spent a combined $2,160,402,000,000 in a year when total federal spending was $4,107,741,000,000. HHS and the Social Security Administration accounted for 52.59 percent of all federal spending.


To be sure, HHS spent money on many other things in fiscal 2018 besides Medicare and Medicaid -- including, for example, $33.2 billion on the National Institutes of Health and $7.97 billion on the Centers for Disease Control and Prevention. But its main charges, as the Congressional Research Service noted, are Medicaid and Medicare.

Medicaid, Medicare and Social Security have one thing in common besides being the primary factors that have driven federal spending above $4 trillion per year: They make people dependent on government.

Terence P. Jeffrey is the editor in chief of 

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