The cost of providing health care has outpaced growth in spending, foundation aid, and inflation for school districts, a report released Monday from the Association of School Business Officials found.

The report, which examined the growth of health care costs over the last five years, found the expense grew from $5.8 billion in 2013 to $7.1 billion in 2018, a 9.9 percent hike in overall school spending. At the same time, the cost of health care has far outpaced the rate of inflation, jumping more than 6 percent in the 2017-18 school year.

“With the constraints of the tax cap and $3.4 billion in foundation aid still due, unsustainable growth in health care costs could force some districts to choose between funding an employee benefit or educational programs for students,” the report found.

The tax cap limits the amount of money school districts and local governments can raise in property taxes to 2 percent or the rate of inflation, whichever is lower. State lawmakers in the budget last week moved to back a permanent extension of the measure, which was due to sunset next year.

Aid from the state is not making up the difference.

“The impact of health care cost increases often surpasses the entire state aid increase school districts receive,” the report found.