National spending for health care is projected to grow 5.7% in 2009 to $2.5 trillion, or 17.3% of gross domestic product, according to a report released today by the Centers for Medicare & Medicaid Services. Contributing to the increase are a 9.9% increase in Medicaid spending associated with the recession, an expected increase in the take-up rate for COBRA coverage, and treatment for the H1N1 flu. Medicare spending growth is projected to slow to 8.1% in 2009 from 8.6% in 2008, partly due to slower growth in hospital spending. In 2010, health care spending growth is expected to slow to 3.9%, 4.7% if Congress eliminates a scheduled 21.3% cut in Medicare payment rates for physicians. By 2019, national health spending is expected to reach $4.5 trillion and 19.3% of GDP. The public share of health care spending is expected to rise to 52% by 2019 from 47% in 2008.