the same process is used to estimate medicaid beneficiaries with the exception that time until death is not included all other health spending grows with the change in the population in each age and sex group multiplied by gdp per capita and ecg estimates of growth in gdp per capita each year over the projection period come from cbolt in a separate macroeconomic framework cbo the projection of ecg begins with estimation of historical ecg for the three main components of health spending medicare medicaid and all other health expenditures and for overall spending on health care