WASHINGTON Even as President Barack Obamas health care law expands health coverage and transforms the way millions of Americans get medical care, it will have little effect on the nations total health care bill, according to a new government report on national health care spending.

Total U.S. spending on health care is expected to continue to surge over the next decade, hitting about $4.8 trillion in 2021, independent economists at the federal Centers for Medicare and Medicaid Services estimate.

That is up from $2.8 trillion this year and will push health care spending to nearly 20 percent of the U.S. economy by the beginning of the next decade.

The new estimates the latest in a series of annual projections from the federal government undermine claims by some critics that the law will dramatically drive up health care spending. At the same time, they also underscore some of the laws limitations.

The growth rate of national health spending is projected to be fairly similar with or without the Affordable Care Act, said Sean Keehan, lead author of the report.

Total spending on health care over the next decade will be approximately 1 percent higher or about $478 billion as result of the new law, even with the federal government spending hundreds of millions of dollars to guarantee nearly all Americans health coverage for the first time.

After the law is fully implemented in 2014, total health care spending is expected to grow slightly more slowly than it would without the law, the report said.

The economists estimate that 30 million more people will gain health coverage over the next decade, with major expansions of the government Medicaid program for the poor and the creation of insurance exchanges, in which consumers who do not get coverage at work will be able to shop for insurance plans starting in 2014.

Many of those people are expected to qualify for federal subsidies that will be available to people making up to four times the federal poverty line, or $92,200, for a family of four.

But the new estimates also show how little the law will do to fundamentally change the trajectory of health care spending.

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Health spending likely to keep rising with or without Obama's plan