In 2023, healthcare programs consumed 31% 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. In 2014, the Congressional Budget Office projected that these four programs will consume half of all federal revenues by 2040. Over the past decade, these projections have largely matched actual outcomes.