Medicaid and CHIP

CBO presents information on enrollment in and spending for Medicaid managed care and analyzes factors affecting those measures—including the types of beneficiaries, geographic areas, and range of services that managed care programs cover.

If current laws remain generally unchanged, CBO projects, federal budget deficits and debt would increase over the next 30 years—reaching the highest level of debt relative to GDP in the nation’s history by far.

CBO and JCT project that the federal subsidies, taxes, and penalties associated with health insurance coverage for people under age 65 will result in a net subsidy from the federal government of $685 billion in 2018.

This report assesses the accuracy of projections that CBO and JCT made in 2010 and 2013 of federal spending for people made newly eligible for Medicaid by the ACA and of subsidies for health insurance purchased through the ACA marketplaces.

CBO and the JCT estimate that enacting the legislation would reduce the deficit by $3.8 billion over the 2018–2027 period without substantially changing the number of people with health insurance coverage, on net.

Over the 2017-2026 period, CBO and JCT estimate, the legislation would reduce the on-budget deficit by at least $133 billion and result in millions fewer people with comprehensive health insurance that covers high-cost medical events.

CBO and JCT project that the federal subsidies, taxes, and penalties associated with health insurance coverage for people under age 65 will result in a net subsidy from the federal government of $705 billion in 2017.

Medicaid spending under the Better Care Reconciliation Act of 2017 would be about 35 percent lower in 2036 compared with CBO’s extended baseline. Such spending under the bill would increase each year throughout the next two decades.

If current laws remained generally unchanged, the United States would face steadily increasing federal budget deficits and debt over the next 30 years—reaching the highest level of debt relative to GDP ever experienced in this country.

CBO reports on the estimated changes in health insurance coverage and premiums that would result from leaving the Affordable Care Act’s insurance market reforms in place while repealing the law’s mandate penalties and subsidies.

Why has Medicare's prescription drug program cost less than anticipated when the program was created? How has competition between plan sponsors affected spending? How do Medicare Part D drug prices compare to those in Medicaid?

People eligible for both Medicare and Medicaid benefits—known as “dual-eligible beneficiaries”—are a varied group, but many have extensive health care needs and account for a disproportionate share of spending on Medicare and Medicaid.

During the past 40 years, federal spending for major means-tested programs and tax credits for low-income households more than tripled as a share of gross domestic product. In 2012, such spending totaled $588 billion.