In 2017, healthcare programs consumed 30% of all federal spending, an increase of 10 times since 1960. Since 1965, various Congresses and Presidents have established four major healthcare programs that have consumed an increasing share of federal outlays. These are Medicare, Medicaid, the Children's Health Insurance Program, and the Affordable Care Act exchange subsidies. Under current federal policies, the Congressional Budget Office projects that these four programs will consume 60% of all federal revenues by 2060.