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US Poised To Boot Legal Immigrants From Medicaid, Including Refugees and Sex-Trafficking Victims
The Congressional Budget Office estimated 100,000 more immigrants will be uninsured by 2034 because of Medicaid eligibility changes under President Trump’s One Big Beautiful Bill Act that take effect Oct. 1. A KFF Health News survey of nine states found many more are at imminent risk of losing health coverage.
Iran war cost $38 billion through July, report says
The U.S. is expected to spend $2 billion to $3 billion per month as the war continues, according to the Congressional Budget Office.
Iran war driving up inflation for Americans, CBO report says
The Congressional Budget office estimates that inflation will continue to rise into the first quarter of next year.
Iran war expected to cause a spike in US inflation, according to budget watchdog
The US war with Iran is expected to increase inflation for the first quarter of 2027, raising costs at a time Americans are growing more concerned about the economy, according to an analysis by the Congressional Budget Office released Tuesday,
Debt Digest | Federal Debt is a Health Care Problem
Welcome David Ditch to the Debt Dispatch! We are pleased to announce a new regular contributor: David Ditch will be joining the Cato Institute as a Policy Analyst for Budget and Entitlement Policy later this week. David has more than a decade of experience in fiscal policy issues, with a particular focus on federal spending. He previously worked at the Senate Budget Committee, the Heritage Foundation, and the Economic Policy Innovation Center. David’s areas of expertise include appropriations, transportation, agriculture, federalism, grantmaking, and policy options for deficit reduction. Originally from the Rochester, N.Y. area, David has a BA in Economics and Political Science from the University of Rochester and a MA in Political Management from George Washington University. David currently lives in Arlington, VA. You may have enjoyed his earlier guest posts: CBO: New Highway Bill Has More Spending, Taxes, and Deficits Trump Administration’s Proposed Changes to Federal Grants Highlight Problems of Big Government Here are this week’s reading links and fiscal facts: The federal debt is largely a health care problem. In a new report, the Congressional Budget Office and Joint Committee on Taxation find that “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.” Cato’s Michael Cannon emphasizes, “The long-term federal debt problem is a health care problem. […] Only two categories of federal outlays will grow faster than gross domestic product (GDP): health care subsidies and interest payments on the debt. The former is, therefore, the primary driver of the latter.” The bond market fears deficits, not the loss of tariff revenue. Responding to a New York Times essay claiming tariff revenue has grown too important for a future administration to unwind, Cato’s Kyle Handley argues: “Bond investors are not attached to customs duties as a line item revenue source. They care about the government’s overall fiscal position.” He continues, “tariff revenue is a side hustle. And the Trump administration has already promised to dole out the funds through schemes like tariff dividend rebates, farm subsidies, and pay-fors on tax cuts or other spending.” Furthermore, “tariff revenue is simply not large enough to transform the government’s fiscal trajectory.” Take net interest for example: it “reached $970 billion in fiscal year 2025, absorbing 18.5 percent of federal receipts. Customs duties accounted for only 3.7 percent of receipts—and that was before refunds (see Figure 2).” Handley concludes, “The real bond-market concern is a large and growing interest bill, persistent budget deficits, and a political system unwilling to bring spending and revenue into alignment.” Medicare’s spending growth is driven by more volume and utilization. A Congressional Research Service report finds that Medicare spending “grew at an average annual rate of 7.3%” from 1985 through 2025, and the trustees project health care expenditures will keep rising “faster than gross domestic product (GDP) in most future years.” Citing CBO, the report attributes Medicare’s projected 2026–2036 spending growth to “23% from higher enrollment, 31% from inflation, and 47% from the growth of inflation-adjusted spending per beneficiary. In other words**, the largest single driver of Medicare spending growth during the next decade is expected to be higher volume and intensity of health care services.”** Boccia and Thakur explain: “as the economy grows, Medicare spending tends to grow at least as fast—and often faster—because the program automatically pays the bill for more and more healthcare consumption by seniors, even as prices rise.” The Fed has little control over market interest rates. Cato’s Jai Kedia documents that the Fed has held its rate target steady since December, yet “nearly every rate Americans actually borrow at has climbed over the same stretch.” Kedia continues, “The Fed did nothing, and the cost of credit went up anyway. […] Markets spent these months repricing macroeconomic events such as sticky core inflation, a volatile energy market driven by the conflict in the Middle East, and global trade disrupted by tariffs, among others. None of that required a policy change to show up in borrowing costs because markets, not the FOMC, set prices.” He concludes, “Accurately priced borrowing rates will come from credible disinflation and disciplined budgets and from a Fed content to follow the economy rather than pretend it leads it.” Nearly half of US farm income comes from taxpayers. Former Reagan OMB director David Stockman notes that “in the most recently completed full year (FY 2025) farmer incomes in the US totaled $97.8 billion, but fully 42.7% or $41.8 billion of that amount came from taxpayers, not the marketplace. Nor is this some kind of one-year aberration. If we look at the most recent decade as a whole, total farm income posted at nearly $708 billion, but, as indicated, fully $322 billion or 45% of this came compliments of US taxpayers.” Cato’s Chris Edwards explains why so little of that income is market-earned: “Farmers are businesspeople, but the government shields them from just about every type of weather and market risk. Furthermore, just about every part of the agricultural industry is subsidized, including insurance, loans, marketing, research, export sales, and land improvements.” The Debt Dispatch is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
The Federal Government’s $33.6 Trillion Health Care Problem
The Congressional Budget Office’s (CBO) latest report on federal health-insurance subsidies estimates the federal government will subsidize health coverage by approximately $2.4 trillion in 2026, by $3.9 trillion by 2036, and by a total of $33.6 trillion over the intervening decade. For all the focus on health care costs in the United States, CBO’s new […]
CBO investigating feasibility of using healthcare fraud savings to fund Trump’s war
The nonpartisan Congressional Budget Office is looking into the effectiveness of the U.S. Department of Health and Human Services’ crackdown on waste and abuse in safety net healthcare programs, and whether the efforts could effectively generate tax revenue the government could then spend elsewhere.
Is the No Surprises Act working? Government watchdog is uncertain
The nonpartisan Congressional Budget Office said it needs more data to determine what savings the 2020 law is bringing to the U.S. healthcare system—but early data indicate it falls short of expectations.
Curing U.S. Health Care, Part II
On March 23, 2010 President Barack Obama signed the Patient Protection and Affordable Care Act — usually referred to either as the Affordable Care Act or as Obamacare — into law. Joe Biden, then the vice president, could be overheard whispering “This is a big fucking deal.” And it was. The ACA, which went into full effect in 2014, created a system of subsidies and regulations designed to make health insurance available to many Americans who had previously been left out. It worked: In 2010 there were 47 million uninsured people in America, but by 2016 this number had dropped to 27 million. This still fell short of the universal health insurance that every other advanced nation has, but it was real progress. In 2017, during his first term, Donald Trump tried to destroy the ACA, replacing it with the American Health Care Act — legislation that would have eliminated most of the provisions that expanded health insurance under Obama. At the time the Congressional Budget Office projected that the G.O.P.’s replacement bill would nearly double the number of Americans without health insurance, increasing the total uninsured population by 23 million and undoing all of the progress achieved under the ACA. However, the attack on Obamacare failed by one vote in the Senate, and the ensuing public backlash against the G.O.P. delivered a large victory in the 2018 midterms to the Democrats. After these developments many observers assumed that the ACA had become a more or less permanent feature of American life. Such assessments, however, failed to take into account the deep hostility of the U.S. right toward policies that expand access to healthcare. As we’ll see, this hostility goes back generations. And the second Trump administration has taken actions that the CBO projects will add 16 million people to the rolls of the uninsured by 2034. How did we get here? And now what? Today’s primer will analyze the political economy of U.S. healthcare since the 1940s and the combination of danger and opportunity created by the current crisis. Beyond the paywall I will discuss the following: US health care on the eve of Trump II 80 years of US health politics The Obamacare story The new assault on healthcare
Expanded SNAP work requirements are kicking in for more states
The new requirements are expected to reduce the average monthly number of SNAP recipients by about 2.4 million people over the next 10 years, according to the Congressional Budget Office
Trump’s National Guard deployments have cost taxpayers nearly $500 million dollars
President Donald Trump’s sweeping deployment of National Guard troops to several major cities across the United States cost taxpayers approximately $496 million from June through December last year, according to an estimate from the Congressional Budget Office.
House GOP health package lowers spending but boosts uninsured
The Congressional Budget Office estimates Republican leaders’ plan would save billions but lead to tens of thousands more without health insurance.