Mandatory Spending Under the Jurisdiction of the House Committee on Energy and Commerce

In response to a request from Ranking Member Boyle and Ranking Member Pallone, CBO provides information about projections of mandatory spending for the 2025–2034 period for the list of programs, excluding Medicare, that the Members indicated are under the jurisdiction of the House Committee on Energy and Commerce.

In CBO’s January 2025 baseline budget projections, mandatory outlays for the accounts that the Members asked about total $8.8 trillion for the 2025–2034 period. Medicaid outlays account for $8.2 trillion, or 93 percent, of that amount (see Table 1 in the PDF).

The Members also asked for two subtotals of projected outlays in Table 1:

• Outlays other than for Medicaid total $581 billion through 2034.
• Outlays other than for Medicaid and CHIP total $381 billion over the 10‑year period.

Among the largest programs other than Medicaid and CHIP are the risk adjustment program, in which health insurers make payments to the government or receive payments from it according to the health of their enrollees ($158 billion), and the Universal Service Fund ($87 billion). The risk adjustment program, however, is budget neutral with revenues offsetting spending. Spending from the Universal Service Fund is derived from fees that are classified as revenues on certain telecommunication services. Outlays for all other programs total $135 billion, on net, over the period, encompassing spending for a variety of federal activities.