Spending on health in the U.S. soared 5.8% in 2015, the fastest annual rate of increase since 2007. Greater access to health insurance and high-priced specialty drugs helped drive the rise to $3.2 trillion in total spending – or $9,990 per person.

Between 2009 and 2013, health spending grew at historically slow rates. That changed in 2014 and 2015 when spending rose as the Affordable Care Act expanded health insurance coverage, according to federal data published in the publication Health Affairs. Officials with the Centers for Medicare and Medicaid Services produced the report.

Between 2013 and 2015, the number of people who enrolled in Medicaid increased 8.4% on average. Meanwhile, the number of people with private health insurance went up 2.5% on average. In 2014 and 2015, the insured share of the population increased 4.9 percentage points and reached 90.9%.

Following, in part, from that rise in coverage, spending for private health insurance accelerated to $1.1 trillion – a 7.2% rise. Medicare spending jumped 4.5%, tallying $646.2 billion. Spending on Medicaid increased 9.7% to $545.1 billion.

While spending on health care is rising, that trend has not yet made the health-care market more fertile ground for sales for promotional product distributors. Health care remains distributors’ second-largest client base, but its overall market share has been on the decline. In 2015, health care accounted for less than 11% of distributors’ overall sales, a steady four-year drop down from 13.8% in 2012.

Why? One reason could be that health-care marketers are becoming increasingly strategic with their promotions amid consolidations, calls to reduce cost and regulatory reforms.