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The nation's health spending will bump up next year as the Affordable Care Act expands insurance coverage to more Americans, and then will grow by an average of 6.2 percent a year over the next decade, according to projections by government actuaries.

That estimate is lower than the typical annual increases before the recession hit. Still, the actuaries forecast that in a decade the health care segment of the nation's economy will be larger than it is today, amounting to a fifth of the gross domestic product in 2022.

They attributed that to the rising number of baby boomers moving into Medicare and the expectation that the economy will improve, according to a study published online in the journal Health Affairs.

The actuaries were not persuaded that cost-cutting experiments in the health law will have an impact. Neither were they convinced that new insurer procedures that change the way doctors, hospitals and others provide services will help. They assumed "modest" savings from those changes from the law.

"It's a little early to tell how substantial those savings will be in the longer term," Gigi Cuckler, an actuary for the Centers for Medicare and Medicaid Services and lead author of the report, told reporters Wednesday.

Still, the Obama administration enthusiastically greeted the report. "We are on the right track to controlling health care costs, thanks in part to the Affordable Care Act," CMS Administrator Marilyn Tavenner said in a statement. "More Americans will have the ability to get the health care they need, and that is a good thing. We have identified several areas where our reforms to control costs are making progress and we must build on those efforts in the years ahead."

But not everyone agrees. "I think it's quite clear from the study that the notion that the health care law fundamentally bends costs is just totally unsupported by facts," James Capretta, a budget adviser to President George W. Bush, said in an interview. "Something more fundamental needs to be done to slow costs than what is in the health law."

Shots - Health News

The 'Hard To Change' Legacy Of Medicare Payments

If you are trying to buy a home, you just got good news: The Federal Reserve said Wednesday it is not going to try to drive up long-term interest rates just yet.

Stock investors are happy for you. They like cheap mortgages too because a robust housing market creates jobs. To celebrate, they bought more shares, sending the Dow Jones industrial average up 147.21 to an all-time high of 15,676.94.

Unfortunately, if you are a retiree who wants a higher return on your savings in the bank — well, sorry. The interest paid to you will be meager.

In fact, the Fed's surprising announcement on interest rates created lots of winners and losers. But before sorting them out, let's first look at what happened:

Policymakers for the central bank met this week and concluded that the U.S. economy is still weak enough to need their help. They said they recognize that the country has seen "improvement in economic activity and labor market conditions," but they added that the Fed still has to tamp down interest rates as officials "await more evidence that progress will be sustained."

Their decision stunned most economists, who believed Fed officials were ready to switch gears away from the long-standing policy of restraining interest rates. The low-rate strategy has been in place throughout the Great Recession and slow recovery.

But many experts say it's time for a change. They think the economy is strong enough to allow interest rates to start to return to historical norms.

Back in June, Fed Chairman Ben Bernanke himself suggested such a switch would come by year's end.

But since then, interest rates on mortgages have been ratcheting up on their own — in anticipation of the coming change. Ditto for interest rates on Treasury securities.

Then on Wednesday afternoon, Bernanke and his fellow policymakers sprang their surprise. After taking a harder look at the most recent information, they decided not to change course after all.

They are worried that congressional Republicans and the White House might have another big showdown this fall, which could rattle markets. And Fed officials don't like seeing the latest higher mortgage rates, which have been scaring off some potential homebuyers.

"The tightening of financial conditions observed in recent months, if sustained, could slow the pace of improvement in the economy and the labor market," the Fed officials said in a statement.

So for the time being, the Fed will not back off its strategy of buying $85 billion a month in bonds to push down on long-term interest rates. It could still taper those purchases by year's end if the policymakers think conditions have changed, but for now, the low-rate strategy is firmly in place.

As a result, these groups cheered the Fed announcement:

Homebuyers and sellers. Thirty-year fixed mortgage rates, which jumped from about 3.5 percent in April to around 4.5 percent recently, are more likely now to halt their upward march. That may prompt more people to get into the homebuying market.

Stock owners. Shares become more valuable when investors can't get much of a return from interest payments on insured securities. So stock prices shot to record highs as of Wednesday's close.

Gold owners. The price of gold surged more than 4 percent to about $1,360. The hike came because gold gets more attractive in times of economic uncertainty and inflation. Some people believe the Fed's current policies eventually will lead to inflation.

And these groups found little to celebrate:

Gas guzzlers. The price of oil — just like gold — rose on inflation fears. By late afternoon, U.S. crude had risen more than $3 per barrel to a high of $108.49.

Conservative savers. If you like to keep your money in very safe securities, your interest income will stay depressed. For example, the yield on the 10-year Treasury note plunged to 2.71 percent after the announcement, down from 2.90 percent.

Job seekers. Not that you needed anyone to tell you this, but the Fed said the economic outlook is not great. It sees growth of 2.3 percent at best this year, down from its earlier forecast of growth as strong as 2.6 percent.

Human rights lawyer Nasrin Sotoudeh was among several political prisoners released by Tehran on Wednesday, just days ahead of a visit by Iran's newly elected moderate president to the United Nations in New York.

Sotoudeh, who had been held since 2010, was one of eight women and three men released, according to the BBC. Reformist politician Mohsen Aminzadeh was also among the prisoners freed.

"I am free from prison today, and I am glad, but I am worried for my friends in prison," Sotoudeh told CNN by telephone from Tehran, adding that she was "free forever," not on temporary release, and planned to resume her legal career.

In January, Sotoudeh, 50, was temporarily released, but apparently detained again later. She first ran into trouble with Iranian authorities for defending political activists and journalists, and "highlighting the execution of juveniles in her country," The Guardian reports.

Sotoudeh had gone on hunger strikes in 2010 and 2012 to protest the conditions of her detention.

Aminzadeh served under President Mohammad Khatami as deputy foreign minister from 1997-2005. Later, he headed the opposition coalition and was arrested amid protests in 2009 over alleged vote rigging by then-President Mahmoud Ahmadinejad. In July, Aminzadeh, who suffers from heart disease, was hospitalized.

Reuters says that former Deputy Minister of Commerce Feizollah Arabsorkhi was also released.

The news agency said the number of prisoners released on Wednesday was not immediately clear, but the BBC put the number at 11.

As House Republican leaders acquiesce to their Tea Party faction and tie a government spending renewal to the defunding of Obamacare, don't look for much cheering from the Senate minority leader's office.

That's because what had largely been House Speaker John Boehner's problem now becomes Kentucky GOP Sen. Mitch McConnell's problem — at least for the next steps of this drama.

The federal government will shut down Oct. 1 unless Congress passes another continuing resolution authorizing further spending. Dozens of Republican lawmakers — led by Sens. Ted Cruz of Texas and Mike Lee of Utah, and helped by the Senate Conservatives Fund, a political committee founded by former South Carolina Sen. Jim DeMint — insist that any such resolution also take away money to implement President Obama's signature health care law.

After initially resisting such a plan, Boehner agreed Wednesday to package the two ideas together and send them to the Democratic-controlled Senate — where it's all but certain to die.

What are the chances that McConnell will be able to pull together the needed votes to prevent Democrats from stripping the Obamacare language out and sending the bill back to the House? Given that a number of Republican senators have already called the linkage strategy a bad idea, probably not so good.

Remember, when Cruz and Lee were circulating their letter promising not to vote for any spending bill that did not "defund" Obamacare, McConnell would not sign it.

All of which means that if and when the Senate eventually passes a "clean CR" back to the House, it could be framed as a failure by McConnell to be an effective enough or conservative enough leader by someone so inclined to see it that way. Someone like, say, Matt Bevin, McConnell's challenger in next year's Republican primary election.

S.V. Dte is the congressional editor on NPR's Washington Desk.