How much does old-age entitlement growth drive the federal deficit?
Core argument: US spending on old-age entitlement programs rose from 2.5% of GDP in the mid-1960s to about 6% in 2000 and almost 9% in 2023, and is projected to keep growing relative to GDP.
In the mid-1960s, spending on old-age entitlement programs was 2.5% of GDP. [It rose to] about 6% of GDP in 2000 to almost 9% in 2023, and is projected to continue to grow relative to GDP. If entitlements for the elderly had remained at their 2000 share of GDP, the 2023 primary deficit would be ~0.8% of GDP rather than 3.3%. The projected growth in these spending programs can be attributed to (1) the size of cohorts expected to enter into retirement (due to past fertility rates and immigration), (2) CBO’s expectation that life expectancy will continue to rise, and (3) rising health costs. Figure 4a shows that cohort sizes are the primary driver of the growth in old-age entitlement spending in the first ten years of CBO’s projections because the still relatively large cohorts born just after the baby boom in 1960–1970 are expected to enter retirement at that time (fertility rates were about 3, on average, from 1960–1970). After 2035, rising life expectancy is the main driver of growth, as the cohorts born in the 1970s and 1980s were much smaller than their predecessors (fertility rates were below 2 in that period). Second, figure 4a shows that if old-age dependency ratios were to remain at their 2024 level throughout the projection, old-age entitlement program spending would grow much more slowly, reaching only 9.8 percent of GDP in 2055 instead of 12.6 percent. Outlays continue to grow even without a rise in the dependency ratio because [per CBO] health costs for Medicare will continue to rise.

