Under policies in place prior to the recent enactment of the health-care bill, budget projections showed that spending for Medicare and Medicaid would roughly double as a share of national income over the next two decades and would continue to rise significantly further in subsequent years.
At this point, the effects of the recent legislation on federal health-care spending over the long term are uncertain, in part because they depend importantly on implementation. But we do know that continued increases in health-care costs at the rate seen in recent decades, together with the aging of the population, would put enormous pressures on the federal budget in coming years.