Federal Subsidies for Health Insurance, 2026 to 2036
Report
Federal subsidies for health insurance total $33.6 trillion over the 2026–2036 period in CBO and JCT's projections. Those estimated subsidies grow from 7.4 percent of gross domestic product (GDP) in 2026 to 8.4 percent of GDP in 2036.
The federal government subsidizes health insurance for most Americans through various programs and tax provisions. The Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) regularly prepare projections of the federal costs of those subsidies and the number of people with health insurance coverage through different sources. This report presents details underlying the projections released in February 2026, including details about health insurance coverage by age and income, factors underlying growth in federal subsidies, and the effects of legislation and administrative actions.
Federal Subsidies. In 2026, federal subsidies for health insurance, net of related payments to the government, are projected to equal $2.4 trillion, or 7.4 percent of gross domestic product (GDP). In CBO and JCT's projections, those subsidies grow by 65 percent, reaching $3.9 trillion, or 8.4 percent of GDP, in 2036. Subsidies for Medicare contribute most to that overall growth, increasing by $900 billion.
Over the entire 2026–2036 period, federal subsidies for health insurance total $33.6 trillion, distributed as follows:
Medicare—$16.1 trillion (48 percent),
Medicaid and the Children's Health Insurance Program (CHIP)—$8.4 trillion (25 percent),
The premium tax credit and related spending—$1.2 trillion (4 percent), and
Supplemental or partial benefits—$0.7 trillion (2 percent).
Health Insurance Coverage. An average of 318 million people are projected to have health insurance in any given month from 2026 to 2036; nearly 50 percent of the total population would be enrolled in employment-based coverage. An average of 36 million people—10 percent of the population—are projected to be uninsured in any given month over that period.
The number of uninsured people in CBO's projections grows from 30 million in 2026 to 37 million in 2036, largely because of provisions of the 2025 reconciliation act that are expected to reduce enrollment in Medicaid and CHIP and, to a lesser extent, in the health insurance marketplaces established by the Affordable Care Act and the Basic Health Program. About 60 percent of uninsured people in 2036 would be eligible for subsidized coverage.
