Status of the 

Social Security 

and Medicare 

Programs

A SUMMARY OF THE

2022 ANNUAL REPORTS

Social Security and Medicare

Boards of Trustees

2022
The Social Security and Medicare Trustees Reports, as well as

this document, are available at the following addresses:

Social Security (OASDI): www.ssa.gov/OACT/TR/2022/

Medicare (HI and SMI): www.cms.gov/OACT/TR/2022

Summary: www.ssa.gov/OACT/TRSUM/

Other information about Social Security benefits and services is available at

www.ssa.gov or by calling toll-free 1-800-772-1213.

Other information about Medicare benefits and services is available at

www.cms.gov or by calling toll-free 1-800-633-4227.
A MESSAGE TO THE PUBLIC:

Each year the Trustees of the Social Security and Medicare trust funds 

report on the current and projected financial status of the two programs. 

The Trustees Reports include extensive information about the current 

operations of these important social insurance programs and careful analysis of their outlook. We believe the reports fully and fairly present the 

current and projected financial condition of the programs. This summary 

of the 2022 reports presents results based on the intermediate set of 

assumptions, which represents our best estimates of likely future demographic, economic, and program-specific conditions.1

Social Security and Medicare both face long-term financing shortfalls 

under currently scheduled benefits and financing. Costs of both programs 

will grow faster than gross domestic product (GDP) through the mid2030s primarily due to the rapid aging of the U.S. population. Medicare 

costs will continue to grow faster than GDP through the late 2070s due to 

projected increases in the volume and intensity of services provided. 

The projections presented include our best estimates of the effects of the 

COVID-19 pandemic. Economic recovery from the 2020 recession has 

been stronger and faster than assumed in last year’s reports, with positive 

effects on the projected actuarial status of the trust funds in these reports. 

At this time, there is no consensus among experts on the lasting effects of 

the COVID-19 pandemic. We currently assume that the pandemic will 

have no net effect on our long-range projections. In addition, the assumptions for this report were determined in mid-February 2022. Developments since then have added to the uncertainty regarding the path of the 

COVID-19 pandemic and the economy in the near term. The Trustees will 

continue to monitor these and any future developments and modify the 

projections in later reports as appropriate.

Based on our best estimates, the 2022 reports determine:

• The Old-Age and Survivors Insurance (OASI) Trust Fund, which 

pays retirement and survivors benefits, will be able to pay scheduled 

benefits on a timely basis until 2034, one year later than reported last 

year. At that time, the fund’s reserves will become depleted and con1 In addition to the results summarized in this document under the best-estimate, intermediate set of 

assumptions, the Trustees Reports include results illustrating ranges of uncertainty in measures of 

trust fund actuarial status. One approach develops results under low-cost and high-cost alternative 

sets of assumptions. A second approach conducts an analysis of the sensitivity of the projection to different assumptions by varying one assumption parameter at a time.
tinuing tax income will be sufficient to pay 77 percent of scheduled 

benefits.

• The Disability Insurance (DI) Trust Fund, which pays disability benefits, is no longer projected to be depleted within the 75-year projection period. By comparison, last year's report projected that it would 

be able to pay scheduled benefits only until 2057.

• The OASI and DI funds are separate entities under law. The report 

also presents information that combines the reserves of these two 

funds in order to illustrate the actuarial status of the Social Security 

program as a whole. The hypothetical combined OASI and DI funds 

would be able to pay scheduled benefits on a timely basis until 2035, 

one year later than reported last year. At that time, the combined 

funds’ reserves will become depleted and continuing tax income will 

be sufficient to pay 80 percent of scheduled benefits. 

• The Hospital Insurance (HI) Trust Fund, or Medicare Part A, which 

helps pay for services such as inpatient hospital care, will be able to 

pay scheduled benefits until 2028, two years later than reported last 

year. At that time, the fund’s reserves will become depleted and continuing total program income will be sufficient to pay 90 percent of 

total scheduled benefits.

• The Supplementary Medical Insurance (SMI) Trust Fund is adequately financed into the indefinite future because current law provides financing from general revenues and beneficiary premiums 

each year to meet the next year’s expected costs. Due to these funding provisions and the rapid growth of its costs, SMI will place 

steadily increasing demands on both taxpayers and beneficiaries.

• For the sixth consecutive year, the Trustees are issuing a determination of projected excess general revenue Medicare funding, as is 

required by law whenever annual tax and premium revenues of the 

combined Medicare funds will be below 55 percent of projected 

combined annual outlays within the next 7 fiscal years. Under the 

law, two such consecutive determinations of projected excess general revenue constitute a “Medicare funding warning.” Under current law and the Trustees’ projections, such determinations and 

warnings will recur every year through the 75-year projection 

period.
Key Changes Since Last Year

The long-range 75-year actuarial deficit of the combined OASI and DI 

Trust Funds decreased from 3.54 to 3.42 percent of taxable payroll since 

the 2021 reports.2 As shown in Table 1, this result was due to the combined effects of changes in methodology, legislation, regulation, economic, demographic, and programmatic assumptions, and recent 

observed experience. The following changes had the largest effects on the 

actuarial deficit.

• One long-range ultimate assumption was changed. The disability 

incidence rate was reduced from 5.0 to 4.8 per thousand individuals 

who meet insured requirements but who are not receiving benefits, 

reflecting that program applications and incidence rates have continued to decline in recent years from a peak in 2010.

• Changes were made to near-term demographic data and assumptions 

to reflect updated birth and immigration data and to better reflect the 

expected effects of the recovery from the pandemic.

• Changes were made to near-term economic data and assumptions 

reflecting that the recovery of employment, earnings, and GDP from 

the 2020 recession has been faster and stronger than projected in last 

year's report, resulting in higher payroll tax receipts and higher revenue from income taxation of Social Security benefits. Real interest 

rates are projected to be slightly higher in the near term, lowering the 

present value of projected future deficits.

• The 75-year valuation period advanced from 2021-95 to 2022-96.

2 The 75-year actuarial balance is a summary measure that calculates the difference between the projected summarized income rate and the summarized cost rate of the trust funds as a percentage of taxable payroll. When that balance is negative, or in “deficit,” projected income over the long-range 

valuation period (2022-96 for the 2022 reports) plus any trust fund reserves at the start of the period 

are insufficient to pay all program costs over the period and leave an adequate “contingency reserve” 

at the end of the period.
Note: Totals do not necessarily equal the sums of components due to rounding. A negative actuarial balance 

is a deficit.

The long-range 75-year actuarial deficit of the HI Trust Fund decreased 

from 0.77 to 0.70 percent of taxable payroll. As shown in Table 2, this 

result was due to the combined effects of economic, demographic, and 

programmatic assumptions, including the changes discussed above for 

OASDI, as well as adjustments to assumptions about private health plan 

spending.

Note: A negative actuarial balance is a deficit.

Table 1.—Change in the OASDI 75-Year Actuarial Balance Since the 2021 Report,

Based on Intermediate Assumptions

[As a percentage of taxable payroll]

Item OASI DI OASDI

Shown in the 2021 report:

Actuarial balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -3.46 -0.08 -3.54

Changes in actuarial balance due to changes in:

Legislation / Regulation. . . . . . . . . . . . . . . . . . . . . . . .00 .00 .00

Valuation period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -.05 -.01 -.06

Demographic data and assumptions. . . . . . . . . . . . . . -.04 .00 -.04

Economic data and assumptions . . . . . . . . . . . . . . . . .13 .00 .13

Disability data and assumptions. . . . . . . . . . . . . . . . . .00 .08 .07

Methods and programmatic data . . . . . . . . . . . . . . . . .01 .00 .01

Total change in actuarial balance. . . . . . . . . . . . . . . . . . .05 .07 .12

Shown in the 2022 report:

Actuarial balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -3.41 -.01 -3.42

Table 2.—Change in the HI 75-Year Actuarial Balance Since the 2021 Report,

Based on Intermediate Assumptions

[As a percentage of taxable payroll]

Shown in the 2021 report:

Actuarial balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -0.77

Changes in actuarial balance due to changes in:

Valuation period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -.01

Base estimate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .00

Private health plan assumptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .07

Hospital assumptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -.03

Other provider assumptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -.02

Other economic and demographic assumptions . . . . . . . . . . . . . . . . . . .06

Total change in actuarial balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .07

Shown in the 2022 report:

Actuarial balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -.70
Conclusion

Lawmakers have many policy options that would reduce or eliminate the 

long-term financing shortfalls in Social Security and Medicare. Taking 

action sooner rather than later will allow consideration of a broader range 

of solutions and provide more time to phase in changes so that the public 

has adequate time to prepare.

By law, there are six Trustees, four of whom serve by virtue of their positions in the Federal Government: the Secretary of the Treasury, the Secretary of Labor, the Secretary of Health and Human Services, and the 

Commissioner of Social Security. The other two Trustees are public representatives appointed by the President, subject to confirmation by the Senate. The two Public Trustee positions have been vacant since 2015. 

By the Trustees:

JANET YELLEN, Secretary of the Treasury,

and Managing Trustee 

of the Trust Funds.

MARTIN J. WALSH, Secretary of Labor,

and Trustee.

XAVIER BECERRA

Secretary of Health and Human Services,

and Trustee.

KILOLO KIJAKAZI, Acting Commissioner of 

Social Security, and Trustee.

1

A SUMMARY OF THE 2022 ANNUAL SOCIAL SECURITY

AND MEDICARE TRUST FUND REPORTS

This summary of the 2022 annual reports presents results based on the 

intermediate set of assumptions, which represents the Trustees’ best estimates of likely future demographic, economic, and program-specific conditions. The COVID-19 pandemic has had significant effects on the 

finances of both the Social Security and Medicare programs in the near 

term. The economic recovery from the brief 2020 recession has been 

stronger and faster than assumed in last year’s reports. The Trustees project that the pandemic and recession will have little effect on the long-term 

actuarial status of both programs. With the course of the pandemic still 

uncertain, the Trustees will continue to monitor developments and modify 

the projections accordingly in future reports.

At the end of 2021, Social Security’s trust fund reserves were 

$2,852 billion, having decreased by $56 billion over the year. The Trustees project that the Old-Age and Survivors Insurance (OASI) Trust Fund 

will be able to pay full benefits on a timely basis until 2034, a year later 

than in last year’s Social Security report. For the first time since the 1983 

Trustees Report, the Disability Insurance (DI) Trust Fund is projected to 

be able to pay full benefits through the end of the 75-year projection 

period (2096 for this year’s report). Last year’s report projected DI Trust 

Fund depletion in 2057. The DI Trust Fund’s reserve depletion date is 

very sensitive to changes in program cash flows and the Trustees have 

lowered anticipated long-range disability incidence rates in this year’s 

report. The number of disabled-worker beneficiaries in current payment 

status continued to fall in 2021, as it has since 2014. 

The projected reserve depletion date for the combined OASI and DI funds 

is 2035, a year later than in last year’s report.1 Over the 75-year projection 

period, Social Security faces an actuarial deficit of 3.42 percent of taxable 

payroll, decreased from the 3.54 percent figure projected last year. The 

main reasons for the smaller deficit are a stronger than expected recovery 

from the pandemic-induced recession, higher expected levels of labor 

productivity, and lower future disability incidence rates that reflect recent 

experience. The actuarial deficit equals 1.2 percent of gross domestic 

product (GDP) through 2096.

Reserves in Medicare’s Hospital Insurance (HI) Trust Fund increased by 

$9 billion to a total of $143 billion at the end of 2021 due in part to repayments of the accelerated and advance payments that were made in 2020. 

1 The OASI and DI Trust Funds are distinct legal entities that operate independently. The two trust 

funds are often considered on a hypothetical combined basis—designated OASDI—to illustrate the 

actuarial status of the Social Security program as whole. 
2

These repayments are assumed to continue until September 2022, when 

the outstanding balance is expected to be fully repaid, resulting in another 

surplus in 2022. After that, the Trustees project deficits in all years until 

the Trust Fund becomes depleted in 2028.

The HI Trust Fund now has a projected depletion date of 2028, two years 

later than in last year’s report. HI income is projected to be higher than 

last year’s estimates because both the number of covered workers and 

average wages are projected to be higher. HI expenditures are expected to 

be lower in the beginning of the short-range period mainly due to the pandemic, but are projected to become larger after 2023 due to higher projected provider payment updates. For the 75-year projection period, the 

HI actuarial deficit has decreased to 0.70 percent of payroll from 

0.77 percent in last year’s report, and is equivalent to 0.3 percent of GDP 

through 2096. 

The Supplementary Medical Insurance (SMI) Trust Fund held $183 billion in assets at the end of 2021. The Trustees expect Parts B and D to be 

adequately financed over the next 10 years and beyond because income 

from premiums and general revenue are reset each year to cover expected 

costs and, for Part B, to ensure an adequate contingency reserve. 

What Are the Trust Funds? Congress established trust funds managed 

by the Secretary of the Treasury to account for Social Security and Medicare income and disbursements. The Treasury credits Social Security and 

Medicare taxes, premiums, and other income to the funds. There are four 

separate trust funds. For Social Security, the OASI Trust Fund pays retirement and survivors benefits and the DI Trust Fund pays disability benefits. For Medicare, the HI Trust Fund pays for Part A inpatient hospital 

and related care. The SMI Trust Fund comprises two separate accounts: 

Part B, which pays for physician and outpatient services, and Part D, 

which covers prescription drug benefits.

The only disbursements permitted from the funds are benefit payments 

and administrative expenses. Federal law requires that the Trustees invest 

all excess funds in interest-bearing securities backed by the full faith and 

credit of the United States. The Department of the Treasury currently 

invests all program revenues in special non-marketable U.S. Government 

securities, which earn interest equal to rates on marketable securities with 

durations defined in law. The balances in the trust funds, which represent 

the accumulated value, including interest, of all prior program annual surpluses and deficits, provide automatic authority to pay benefits.

Who Are the Trustees? By law, there are six Trustees, four of whom 

serve by virtue of their positions in the Federal Government: the Secretary 

of the Treasury, the Secretary of Labor, the Secretary of Health and 

Human Services, and the Commissioner of Social Security. The other two 

Trustees are public representatives appointed by the President, subject to 
3

confirmation by the Senate. The two Public Trustee positions have been 

vacant since July 2015.

How Are Social Security and Medicare Financed? For OASDI and HI, 

the major source of financing is payroll taxes on earnings paid by employees and their employers. Self-employed workers pay the equivalent of the 

combined employer and employee tax rates. During 2021, an estimated 

179.3 million people had earnings covered by Social Security and paid 

payroll taxes; for Medicare the corresponding figure was 183.1 million. 

Current law establishes payroll tax rates for OASDI, which apply to earnings up to an annual maximum ($147,000 in 2022). The maximum ordinarily increases each year with the growth in the nationwide average 

wage. In contrast to OASDI, covered workers pay HI taxes on total earnings. The scheduled payroll tax rates (in percent) for 2022 and later are 

shown in Table 1. 

There is an additional HI tax equal to 0.9 percent of earnings over 

$200,000 for individual tax return filers, and on earnings over $250,000 

for joint return filers.

Taxation of Social Security benefits is another source of income for the 

Social Security and Medicare trust funds. Beneficiaries with incomes 

above $25,000 for individuals (or $32,000 for married couples filing 

jointly) pay income taxes on up to 50 percent of their benefits, with the 

revenues going to the OASDI trust funds. This income from taxation of 

benefits made up about 3 percent of Social Security’s income in 2021. 

Those with incomes above $34,000 (or $44,000 for married couples filing 

jointly) pay income taxes on up to 85 percent of benefits, with the additional revenues going to the HI Trust Fund. This income from taxation of 

benefits represented about 7 percent of HI Trust Fund income in 2021.

The trust funds also receive income from interest on their accumulated 

reserves, which are invested in U.S. Government securities. In 2021, 

interest income made up 6 percent of total income to the OASDI trust 

funds and less than 1 percent for both HI and SMI.

Payments from the General Fund of the U.S. Treasury financed about 

79 percent of SMI Part B and Part D costs in 2021. These payments were 

higher than usual because the Continuing Appropriations Act, 2021 and 

Other Extensions Act required a transfer to Part B to cover the premium 

income that was lost in 2021 as a result of the legislated specification of 

Table 1: 2022 PAYROLL TAX RATES

[In percent]

OASI DI OASDI HI Total

Employees . . . . . . 5.30 0.90 6.20 1.45 7.65

Employers . . . . . . 5.30 0.90 6.20 1.45 7.65

Combined total. . . 10.60 1.80 12.40 2.90 15.30
4

the aged actuarial rate calculation. The money will be repaid over time. 

Monthly premiums paid by enrollees, or in the case of low-income beneficiaries, monthly Part B premiums paid on their behalf by Medicaid for 

Part B and by Medicare for Part D, cover most of the remaining SMI 

costs. Under current law, Part B and Part D premium amounts increase as 

the estimated costs of those programs rise.

In 2022, the Part B standard monthly premium is $170.10. There are also 

income-related monthly adjustment amounts for Part B beneficiaries 

whose modified adjusted gross income exceeds a specified threshold. In 

2022, the threshold is $91,000 for individual tax return filers and 

$182,000 for joint return filers. Income-related monthly adjustment 

amounts range from $68.00 to $408.20 per month in 2022.

In 2022, the Part D “base monthly premium” is $33.37. Actual premium 

amounts charged to Part D beneficiaries depend on the specific plan they 

have selected and are projected to average around $32 for standard coverage in 2022. Part D enrollees with incomes exceeding the thresholds 

established for Part B must also pay income-related monthly adjustment 

amounts in addition to their normal plan premium. For 2022, the adjustments range from $12.40 to $77.90 per month. Part D also receives payments from States that partially compensate for the Federal assumption of 

Medicaid responsibilities for prescription drug costs for individuals eligible for both Medicare and Medicaid. In 2021, State payments covered 

about 11 percent of Part D costs.

What Were the Trust Fund Operations in 2021? At the end of 2021, 

56.0 million people received OASI benefits, 9.2 million received DI benefits, and 63.8 million were enrolled under Medicare. A summary of the 

trust fund operations is shown below (Table 2). The OASI Trust Fund 

reserves declined in 2021; DI, HI, and SMI Trust Fund reserves increased.

Table 2: TRUST FUND OPERATIONS, 2021

[In billions]

OASI DI HI SMI

Reserves (end of 2020) . . . . . . . . $2,811.7 $96.6 $134.1 $143.3

Income during 2021 . . . . . . . . . . 942.9 145.5 337.4 550.2

Cost during 2021. . . . . . . . . . . . . 1,001.9 142.6 328.9 510.4

Net change in reserves . . . . . . -59.1 2.8 8.5 39.7

Reserves (end of 2021) . . . . . . . . 2,752.6 99.4 142.7 183.0

Note: Totals do not necessarily equal the sums of rounded components.
5

Table 3 shows payments, by category, from each trust fund in 2021.

In 2021, the cost of administrative expenses, shown as a percentage of 

program costs from each trust fund, was:

Trust fund income, by source, in 2021 is shown in Table 5.

In 2021, Social Security’s total cost exceeded total income, including 

interest on trust fund asset reserves, by $56 billion. The Trustees project 

that total cost will exceed total income in all future years. 

In 2021, the HI Trust Fund’s total income ($337 billion), including 

$3 billion of interest income (Table 5), exceeded program expenditures 

($329 billion) by $9 billion as repayment began of accelerated and 

advance payments made from the Trust Fund to providers in 2020. Continuing repayments will result in a larger surplus in 2022. The Trustees 

project annual deficits for 2023 and the remainder of the projection 

period, with depletion of reserves in 2028. For SMI, general revenues, 

Table 3: PROGRAM COST, 2021

[In billions]

Category OASI DI HI SMI

Benefit payments . . . . . . . . . . . . $993.1 $140.1 $323.6 $504.9

Railroad Retirement financial 

interchange . . . . . . . . . . . . . . . 4.8 0.1 — —

Administrative expenses . . . . . . 4.0 2.5 5.3 5.5

Total . . . . . . . . . . . . . . . . . . . . . . 1,001.9 142.6 328.9 510.4

Note: Totals do not necessarily equal the sums of rounded components.

Table 4: ADMINISTRATIVE EXPENSES, 2021

[As a percentage of total program costs]

OASI DI HI SMI

Administrative expenses. . . . 0.4 1.7 1.6 1.1

Table 5: PROGRAM INCOME, 2021

[In billions]

Source OASI DI HI SMI

Payroll taxes . . . . . . . . . . . . . . . $838.2 $142.4 $302.5 —

Taxes on OASDI benefits . . . . . 37.2 0.5 25.0 —

Interest earnings . . . . . . . . . . . . 67.5 2.6 2.6 $2.7

General Fund reimbursements . a a 1.4 12.5

General revenues. . . . . . . . . . . . — — — 391.4

Beneficiary premiums . . . . . . . . — — 4.2 127.9

Transfers from States. . . . . . . . . — — — 12.1

Other . . . . . . . . . . . . . . . . . . . . . a — 1.7 3.6

Total. . . . . . . . . . . . . . . . . . . . . . 942.9 145.5 337.4 550.2 a Less than $50 million.

Note: Totals do not necessarily equal the sums of rounded components. 
6

which are set prospectively based on projected costs, are the largest 

source of income.

What Is the Outlook for Short-Term Trust Fund Adequacy? The 

“trust fund ratio” is the value of trust fund asset reserves at the start of a 

year expressed as a percentage of the projected costs for the ensuing year. 

The Trustees measure the short-range adequacy of the OASI, DI, and HI 

Trust Funds with this ratio. A trust fund ratio of 100 percent or more, or a 

ratio that is expected to reach 100 percent within 5 years and remain at or 

above 100 percent through the short-range period, indicates that the 

fund’s reserves are adequate in the short range. That level of projected 

reserves for any year suggests that even if cost exceeds income, the trust 

fund reserves, combined with annual tax revenues, would be sufficient to 

pay full benefits for several years. Chart A shows the trust fund ratios 

through 2096 under the intermediate assumptions.

By this measure, the OASI Trust Fund is not financially adequate 

throughout the short-range period (2022-31). The OASI Trust Fund fails 

the short-range test because its trust fund ratio is projected to decline from 

251 percent at the beginning of 2022 to 87 percent at the beginning of 

2030. The Trustees project the DI Trust Fund to be adequately financed 

throughout the short-range period. Its trust fund ratio was 68 percent at 

the beginning of 2022 and increases to a value of 100 percent by the 

 Chart A–OASI, DI, and HI Trust Fund Ratios

[Asset reserves as a percentage of annual cost]

0%

50%

100%

150%

200%

250%

300%

350%

400%

450%

1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080 2090 2100

Calendar year

Ż Historical Projected Ź

OASI DI

HI
7

beginning of the fifth projected year (2026) and continues to increase for 

the remainder of the short-range period.

The HI Trust Fund has not met the Trustees’ formal test of short-range 

financial adequacy since 2003. Its trust fund ratio was 40 percent at the 

beginning of 2022 based on the year’s anticipated expenditures, and the 

projected ratio does not rise to 100 percent within 5 years. Projected HI 

Trust Fund asset reserves become fully depleted in 2028.

The Trustees apply a less stringent annual “contingency reserve” test to 

SMI Part B asset reserves because (1) the financing for that account is set 

each year to meet expected costs, and (2) the overwhelming portion of the 

financing for that account consists of transfers from the Treasury’s General Fund and beneficiary premiums, which were 73 percent and 

25 percent, respectively, of total Part B income in calendar year 2021. 

The Centers for Medicare & Medicaid Services (CMS) calculate the 

Part D premiums paid by enrollees based on the plan bids. Moreover, lawmakers established flexible appropriation authority for Part D to allow 

additional general revenue transfers if costs are higher than anticipated, 

limiting the need for a contingency reserve in that account.

What Are Key Dates in OASI, DI, and HI Financing? The 2022 

reports project that the HI Trust Fund will be depleted in 6 years and the 

OASI Trust Fund in 12 years. The DI Trust Fund is projected to be adequate to pay full scheduled benefits through the end of the long-range 

period (2096). Table 6 shows key dates for the three trust funds as well as 

for the combined OASDI trust funds.2

The OASI Trust Fund has a projected reserve depletion date of 2034, a 

year later than in last year’s report. At that time, 77 percent of scheduled 

OASI benefits would be payable, declining to 72 percent in 2096.

The Trustees project that DI Trust Fund reserves will increase annually 

through 2089 before gradually declining through the end of the 75-year 

projection period (2096) when the trust fund ratio would equal 47 percent. 

2 HI results in this section of the Summary are on a cash rather than the incurred expenditures basis.

Table 6: KEY DATES FOR THE TRUST FUNDS 

OASI DI OASDI HI

First year cost exceeds income 

excluding interesta. . . . . . . . . . . . . . . . . . . 

a Dates indicate the first year a condition is projected to occur and to persist annually thereafter through 

2096.

2010 2044 2010 2008

First year cost exceeds total incomea . . . . 2021 2090 2021 2023

Year trust fund reserves are depleted . . . . 2034 b

bThe trust fund is not projected to become depleted during the 75-year period ending in 2096.

2035 2028
8

Program income is sufficient to pay full scheduled benefits throughout the 

long-range period. 

The combined OASI and DI Trust Fund reserves have a projected depletion date of 2035, a year later than in last year’s report. After the depletion 

of reserves, continuing tax income would be sufficient to pay 80 percent 

of scheduled benefits in 2035, and 74 percent by 2096. The Trustees project that the combined OASI and DI Trust Fund reserves will continue to 

decrease in 2022 because total cost ($1,243 billion) is expected to exceed 

total income ($1,196 billion) and that OASDI total cost will continue to 

exceed total income each year throughout the 75-year projection period. 

Net redemptions of trust fund asset reserves with Treasury General Fund 

payments will be required to pay scheduled benefits until projected depletion of these reserves in 2035, a year later than in last year’s report.

The projected HI Trust Fund depletion date is 2028, two years later than 

reported last year. Under current law, scheduled HI tax and premium 

income would be sufficient to pay 90 percent of estimated HI cost after 

trust fund depletion in 2028, declining to 80 percent by 2046, and then 

gradually increasing to 93 percent by 2096. The Medicare report projects 

an increase in HI Trust Fund asset reserves in 2022 as total income 

($386 billion) is expected to exceed total cost ($356 billion). Anticipated 

2022 income includes net repayments of $34.4 billion for the Medicare 

Accelerated and Advance Payments Program. After 2022, anticipated 

annual HI cost exceeds program income throughout the 75-year projection period.

What Is the Outlook for Future Social Security and Medicare HI 

Costs and Income in Relation to Taxable Earnings? Because the primary source of income for OASDI and HI is the payroll tax, it is useful in 

assessing the financial outlook to express the programs’ incomes and 

costs as percentages of taxable payroll—that is, showing their size relative to the base of worker earnings taxed to support each program 

(Chart B).

When interpreting Chart B, consider that the two programs have different 

taxable payrolls. HI taxable payroll is about 25 percent larger than that of 

OASDI because the HI payroll tax is imposed on all covered earnings 

while OASDI taxes apply only to earnings up to a maximum ($147,000 in 

2022), which ordinarily is adjusted each year. Thus, the percentages in 

Chart B are comparable within each program, but not across programs.

Both the OASDI and HI annual cost rates rise over the long run from their 

2021 levels (13.92 and 3.42 percent of taxable payroll, respectively). Projected Social Security cost grows to 18.32 percent of taxable payroll for 

2078, and then decreases to 17.64 percent in 2096. The projected Medicare HI cost rate rises to 4.89 percent of taxable payroll in 2046, and 
9

thereafter remains at about that level, eventually declining slightly to 4.79 

percent in 2096.

The OASDI and HI income rates in Chart B include payroll taxes and 

taxes on OASDI benefits, but not interest payments. The projected 

OASDI income rate is stable at about 13 percent throughout the longrange period. The HI income rate rises gradually from 3.40 percent in 

2021 to 4.45 percent in 2096 primarily due to the higher payroll tax rates 

for high earners that began in 2013. Individual tax return filers with earnings above $200,000, and joint return filers with earnings above 

$250,000, pay an additional 0.9 percent tax on earnings above these earnings thresholds. An increasing fraction of all earnings will be subject to 

the higher tax rate over time because the thresholds are not indexed. By 

2096, an estimated 80 percent of workers would pay the higher rate.

What Is the Long-Range Actuarial Balance of the OASI, DI, and HI 

Trust Funds? Another way to view the outlook for payroll tax-financed 

trust funds (OASI, DI, and HI) is to consider their actuarial balances for 

the 75-year valuation period. The actuarial balance measure includes the 

trust fund asset reserves at the beginning of the period, an ending fund 

balance equal to the 76th year’s costs, and projected costs and income 

during the valuation period, all expressed as a percentage of taxable payroll for the 75-year projection period. The actuarial balance is the difference between the summarized income rate and the summarized cost rate 

 Chart B–OASDI and HI Income and Cost as Percentages 

of Their Respective Taxable Payrolls

0%

5%

10%

15%

20%

1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080 2090

Calendar year

Ż Historical Projected Ź

OASDI Cost

OASDI Income

HI Cost

HI Income
10

as a percentage of taxable payroll over the valuation period. A negative 

actuarial balance is an actuarial deficit. Note that actuarial balance is not 

relevant for the Medicare SMI Trust Fund because Federal law sets premium increases and general revenue transfers at the levels necessary to 

bring the SMI Trust Fund into annual balance.

An actuarial deficit represents the average amount of change in income or 

cost that is needed throughout the valuation period in order to achieve 

actuarial balance. The actuarial balance for the period equals zero if cost 

can be met for the period as a whole and trust fund asset reserves at the 

end of the period are equal to the following year’s cost. The OASI, DI, 

and HI Trust Funds all have long-range actuarial deficits as shown in 

Table 7.

Note: Totals do not necessarily equal the sums of rounded components.

For the combined OASI and DI Trust Funds, the annual deficit, expressed 

as the difference between the cost rate and income rate for a particular 

year, was 1.54 percent of taxable payroll in 2021. Compared with last 

year’s report, the Trustees project smaller annual deficits for Social Security throughout the 75-year projection period, on average about 0.18 percentage point lower. For 2096, the projected annual deficit is 4.25 percent 

of taxable payroll in this report, compared to 4.35 percent in last year’s 

report.

Projected annual deficits for the combined OASI and DI programs gradually increase from 1.26 percent of taxable payroll in 2022 to 4.89 percent 

in 2078, before declining to 4.25 percent of taxable payroll in 2096 

(Chart B). The relatively large variation in annual deficits for the Social 

Security trust funds indicates that a one-time, uniform increase in the payroll tax rate for all years starting in 2022 sufficient to achieve actuarial 

balance would result in large annual surpluses early in the period, but followed by increasing deficits in later years. Sustainable solvency beyond 

the end of the 75-year period would require larger payroll tax rate 

increases and/or benefit reductions than those needed on average for this 

report’s long-range period (2022-96).

In 2021, the HI annual deficit—again, expressed as the difference 

between the cost rate and income rate—was 0.03 percent of taxable payroll and is expected to rise to 0.04 percent in 2022. Projected annual deficits increase gradually to a high of 0.99 percent of taxable payroll in 2044 

Table 7: LONG-RANGE ACTUARIAL DEFICIT OF THE 

OASI, DI, AND HI TRUST FUNDS

[Percent of taxable payroll]

OASI DI OASDI HI

Actuarial

Deficit . . . . . . . . . . . . . . . . . . 3.41 0.01 3.42 0.70
11

before declining gradually to 0.35 percent in 2096. The projected HI cost 

rates in this year’s Medicare report are lower than those from the 2021 

report because of (i) lower health care utilization through 2028 due to the 

pandemic and (ii) higher taxable payroll in all years resulting from the 

changing economic and demographic assumptions. The Trustees expect 

annual HI deficits to increase during the next two decades as cost rates 

grow faster than income rates. The cost rate increases primarily due to rising per beneficiary spending and the aging of the baby boom population. 

Throughout the long-range period, cost rate growth is constrained by the 

productivity reductions in provider payments. At the same time, income 

rates increase as a larger share of earnings becomes subject to the additional 0.9 percent payroll tax and a larger share of Social Security benefits 

becomes subject to income tax that is credited to the HI Trust Fund. 

The financial outlooks for both OASDI and HI depend on a number of 

demographic and economic assumptions. Nevertheless, the actuarial deficit in each of these programs is large enough that averting trust fund 

depletion under current-law financing is extremely unlikely. An analysis 

that allows plausible random variations around the intermediate assumptions indicates that OASDI trust fund depletion is highly probable 

(denoted by a 95-percent confidence interval) by 2043.

How Has the Financial Outlook for Social Security and Medicare 

Changed Since Last Year? The COVID-19 pandemic and 2020 recession have had significant effects on the short-range finances of both programs. The economic recovery has been stronger than assumed in last 

year’s reports with faster-than-expected increases in employment, earnings, and GDP in late 2020, 2021, and early 2022. This year’s reports 

incorporate increases in both the level of total economy labor productivity 

and the level of potential GDP for 2021 and later years. Disabled-worker 

application and incidence rates continued to fall in 2020 and 2021, as they 

have since 2010, prompting the Trustees to reduce the assumed longrange disability incidence rate from 5.0 to 4.8 per thousand exposed. 

Although the ultimate demographic assumptions remain unchanged from 

last year, the 2022 reports incorporate slightly lower fertility rates and 

smaller pandemic effects on immigration in the near term. Taken together, 

these data and assumptions cause the projected reserve depletion date for 

the combined OASI and DI Trust Funds to move from 2034 to 2035. For 

Medicare, there have been notable impacts on short-term financing and 

spending patterns, but the Trustees expect these to play out by 2024, 

although lingering morbidity effects will continue through 2028. There is 

an unusually large degree of uncertainty associated with the eventual 

effects of COVID-19 and future projections could change significantly as 

more information becomes available. 

Under the intermediate assumptions, the combined OASDI trust funds 

now have a projected 75-year actuarial deficit equal to 3.42 percent of 

taxable payroll, compared with the 3.54 percent figure reported last year. 
12

The projected depletion date for the combined asset reserves is 2035, a 

year later than in last year’s report. Advancing the valuation period by one 

year to include 2096, a year with a large negative balance, alone increases 

the actuarial deficit by 0.06 percent of taxable payroll. That factor is more 

than offset by the combined effects of changes in law, methods, starting 

values, and assumptions that decrease the actuarial deficit by 0.17 percent 

of taxable payroll and result in the net reduction in the actuarial deficit of 

0.12 percentage point. Roughly 60 percent of the change in the actuarial 

balance for the combined OASDI trust funds is attributable to the 

improved outlook for the DI Trust Fund.

Medicare’s HI Trust Fund has a long-range actuarial deficit equal to 

0.70 percent of taxable payroll, down from 0.77 in last year’s report. This 

change is mainly due to an improved method for allocating projected 

Medicare Advantage spending between Parts A and B, which lowers projected Part A private health care spending, and economic and demographic assumptions that were partially offset by changes in hospital and 

other provider assumptions. The anticipated date of depletion of the HI 

Trust Fund is now 2028. Projected HI income is higher than in last year’s 

report due to increases in the expected number of covered workers and 

higher average wages. HI expenditures are projected to be lower early in 

the short range because of the pandemic but larger after 2023 due to 

higher projected provider payment updates. 

Due to the nature of the financing for both Part B and Part D of SMI, each 

account is separately in financial balance under current law, as they were 

last year. The projected Part B costs (expressed as a share of GDP) in this 

year’s Medicare report are slightly lower than the estimates in last year’s 

report in the near term due mainly to higher anticipated GDP, but are 

slightly higher in the long term, with high spending growth for outpatient 

hospital services and physician-administered drugs being contributing 

factors. The Part D projected cost (as a share of GDP) are slightly lower 

due to (i) higher anticipated GDP and (ii) lower spending attributable to 

slower price growth and higher direct and indirect remuneration (DIR), 

which are partially offset by higher enrollment. SMI spending was 

2.4 percent of GDP in 2021, is expected to grow to 4.0 percent within 25 

years, and further increase to 4.5 percent of GDP in 2096.

What Is the Outlook for Future Social Security and Medicare Costs 

in Relation to GDP? Future Social Security and Medicare costs consist 

of scheduled benefits and administrative expenses. To better understand 

the size of these future projected costs, one can compare them to GDP, the 

most frequently used measure of the total output of the U.S. economy 

(Chart C).
13

Under the intermediate assumptions employed in the reports, the costs of 

these programs as a percentage of GDP increase substantially through 

about 2035 because: (1) the number of beneficiaries rises rapidly as the 

baby-boom generation retires; and (2) the lower birth rates that have persisted since the baby boom cause slower growth of employment and GDP.

Social Security’s annual cost as a percentage of GDP is projected to 

increase from 5.0 percent in 2022 to about 6.0 percent for 2039. It then 

declines slightly through 2049, then resumes rising to a peak of 6.2 percent in 2077, before gradually decreasing to 5.9 percent by 2096. Medicare’s annual cost rises from 3.9 percent of GDP in 2022 to 6.2 percent by 

2046 due mainly to the rapid growth in the number of beneficiaries, and 

then increases further to 6.5 percent by 2096. The growth in health care 

cost per beneficiary becomes the larger factor later in the valuation 

period, particularly in Part D.

In 2022, the combined cost of the Social Security and Medicare programs 

is about 8.9 percent of GDP. The Trustees project an increase to 

11.6 percent of GDP by 2035 and to 12.3 percent by 2096, with most of 

the increase coming from Medicare. In 2022, Medicare’s annual cost is 

about 79 percent of Social Security’s annual cost. By 2039, Medicare will 

be more costly than Social Security. During the last 25 years of the longrange period, Medicare is, on average, about 8 percent more costly than 

Social Security.

 Chart C–Social Security and Medicare Costs as a Percentage of GDP

0%

2%

4%

6%

8%

10%

1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080 2090

Calendar year

Ż Historical Projected Ź

HI + SMI

OASI + DI
14

The projected costs for OASDI and HI as shown in Chart C and elsewhere 

in this summary assume that the full scheduled current-law benefits will 

continue to be paid without regard to whether the trust funds will have 

sufficient resources to meet these obligations. These programs, however, 

are not allowed to pay any benefits beyond what is available from annual 

income and trust fund reserves, and they cannot borrow money. Therefore, after the trust fund reserves become depleted, the amount of benefits 

that would be paid under current law is lower than shown in Chart C. The 

projected Medicare costs assume realization of the full estimated savings 

set out in the Affordable Care Act will be achieved. As described in the 

Medicare Trustees Report, the projections for Medicare assume that the 

cost-saving measures will be effective, in particular, the lower increases 

in Medicare payment rates to most categories of health care providers.

How Will Cost Growth in the Different Parts of Medicare Change the 

Sources of Program Financing? Over time, general revenues and beneficiary premiums will finance a growing share of Medicare costs. Chart D 

shows scheduled cost and non-interest revenue sources under current law 

for HI and SMI combined as a percentage of GDP. The total cost line is 

the same as displayed in Chart C and shows that the Trustees project 

Medicare cost to rise to 6.5 percent of GDP by 2096.

Projected revenue from payroll taxes and income taxes on OASDI benefits credited to the HI Trust Fund increases from 1.5 percent of GDP in 

2022 to 1.8 percent in 2096 under current law. During the same period, 

however, projected general revenue transfers to the SMI Trust Fund 

increase more rapidly from 1.7 percent of GDP in 2022 to 3.1 percent in 

2096, and beneficiary premiums increase from 0.6 to 1.3 percent of GDP. 

Thus, the share of total non-interest Medicare income from taxes declines 

(from 39 percent to 29 percent) while the general revenue share rises 

(from 43 percent to 49 percent), as does the share of premiums (from 

16 percent to 20 percent). Medicare’s distribution of financing changes in 

large part because the Trustees project that costs for Part B and especially 

Part D—the Medicare components that are financed mainly from general 

revenues—increase at a faster rate than for Part A. The projected annual 

HI financial deficits beyond 2035 are about 0.4 of GDP through 2057, and 

they gradually decline to about 0.1 percent of GDP by 2096. There is no 

provision under current law to finance that shortfall through general revenue transfers or any other revenue source.
15

Each year the law requires the Board of Trustees to determine whether the 

annual difference between Medicare costs and dedicated financing 

sources exceeds 45 percent of total Medicare cost in any of the next 7 fiscal years. (These dedicated financing sources are shown by the bottom 

four layers of Chart D.) Because the Trustees estimate this difference to 

exceed the 45-percent threshold in fiscal year 2025, they are issuing a 

determination of “excess general revenue Medicare funding” in this 

year’s report. This is the sixth consecutive report with that determination. 

Issuing that determination for at least 2 consecutive years triggers a statutory “Medicare funding warning,” which requires that the President submit to Congress proposed legislation to respond to the warning within 15 

days after the submission of the Fiscal Year 2024 Budget. The law then 

requires Congress to consider the legislation on an expedited basis.

 Chart D–Medicare Cost and Non-Interest Income by Source

as a Percentage of GDP

0%

1%

2%

3%

4%

5%

6%

7%

1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080 2090

Calendar year

Ż Historical Projected Ź Total Cost

Deficit

General

Revenue 

Transfers

State Transfers

& Drug Fees

Premiums

Tax on OASDI 

Benefits

Payroll 

Taxes
Because the two Public Trustee positions are currently vacant, there is no 

Message from the Public Trustees for inclusion in the Summary of the 

2022 Annual Reports.


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2022