Now, that includes some big categories of health care spending that state analysts intentionally left out of their estimate — Medicare, Medicaid, Veterans Administration, Tricare and state employee health insurance. Their goal was to figure out how much new spending the state would have to take on, so they left out costs for people who already get their health coverage from the government in one form or another. The $24 billion represents the additional costs the state would have to incur to cover people who now pay for their own health insurance or get it through an employer, plus the expense of providing coverage to people who are now uninsured. The DLS analysis includes no estimate of how much businesses are paying for their employee health plans now, and CMS data don’t give an answer that fits precisely into the methods the state used to model costs. But in the aggregate, Marylanders spent $17.3 billion on private health insurance in 2014, which, based on the historical rate of growth, would be about $21 billion today.