Spending · subcategory

Health care services

Medicaid, CHIP, ACA premium tax credits, and health benefits for federal retirees. Part of Health (excluding Medicare). FY2025 net outlays: $923B, 94% of the category and 13.16% of all federal spending. The largest program is Medicaid ($668B).

$923B

FY2025 net outlays

94%

of Health (excluding Medicare)

+8.0%

change from FY2024 ($854B)

programs (accounts) with FY2025 spending

Every program

50 accounts with FY2025 spending in Health care services, largest first. Hover or tap a bar for details.

Mandatory (set by standing law)Discretionary (set by yearly appropriations)

MedicaidGrants to States for Medicaid · Centers for Medicare and Medicaid Services

$668B

ACA premium tax creditsRefundable Premium Tax Credit · Internal Revenue Service

$129B

CHIP (Children's Health Insurance Program)Children's Health Insurance Fund · Centers for Medicare and Medicaid Services

$23.1B

Health insurance for federal retireesGovernment Payment for Annuitants, Employees Health Benefits · Office of Personnel Management

$16.2B

Department of Defense Medicare-Eligible Retiree Health Care FundRetiree Health Care

$13.0B

Health Resources and ServicesHealth Resources and Services Administration

$12.7B

Risk Adjustment Program PaymentsCenters for Medicare and Medicaid Services

$11.2B

CDC-wide Activities and Program SupportCenters for Disease Control and Prevention

$10.1B

Substance Abuse and Mental Health Services AdministrationSubstance Abuse and Mental Health Services Administration

$8.34B

Public Health and Social Services Emergency FundDepartmental Management

$8.17B

Indian Health ServicesIndian Health Service

$5.23B

Postal Service Retiree Health Benefits FundOffice of Personnel Management

$4.70B

Research, Development, and ProcurementAdministration for Strategic Preparedness and Response

$1.53B

Indian Health FacilitiesIndian Health Service

$1.33B

Contract Support CostsIndian Health Service

$1.24B

Nonrecurring Expenses FundDepartmental Management

$1.21B

Retirement Pay and Medical Benefits for Commissioned OfficersProgram Support Center

$878M

Defense Production Act Medical Supplies EnhancementDepartmental Management

$759M

Center for Medicare and Medicaid InnovationCenters for Medicare and Medicaid Services

$720M

State Grants and DemonstrationsCenters for Medicare and Medicaid Services

$695M

Show 30 smaller programs

World Trade Center Health Program FundCenters for Disease Control and Prevention

$680M

United Mine Workers of America 1993 Benefit PlanUnited Mine Workers of America Benefit Funds

$664M

General Departmental ManagementDepartmental Management

$614M

Payments for Tribal LeasesIndian Health Service

$542M

Maternal, Infant, and Early Childhood Home Visiting ProgramsHealth Resources and Services Administration

$476M

Operations, Preparedness, and Emergency ResponseAdministration for Strategic Preparedness and Response

$436M

Abandoned Mine Reclamation FundOffice of Surface Mining Reclamation and Enforcement

$401M

Employees and Retired Employees Health Benefits FundsOffice of Personnel Management

$319M

Vaccine Injury Compensation Program Trust FundHealth Resources and Services Administration

$252M

United Mine Workers of America 1992 Benefit PlanUnited Mine Workers of America Benefit Funds

$111M

Agency for Toxic Substances and Disease Registry, Toxic Substances and Environmental Public HealthCenters for Disease Control and Prevention

$89M

No Surprises Implementation FundDepartmental Management

$89M

Office of Inspector GeneralOffice of the Inspector General

$81M

Consumer Operated and Oriented Plan Program AccountCenters for Medicare and Medicaid Services

$73M

Miscellaneous Trust FundsProgram Support Center

$68M

Child Enrollment Contingency FundCenters for Medicare and Medicaid Services

$54M

Infectious Diseases Rapid Response Reserve FundCenters for Disease Control and Prevention

$52M

HHS Accrual Contribution to the Uniformed Services Retiree Health Care FundProgram Support Center

$38M

Buildings and FacilitiesCenters for Disease Control and Prevention

$30M

Postal Service Health Benefits Program Implementation FundOffice of Personnel Management

$29M

Early Retiree Reinsurance ProgramCenters for Medicare and Medicaid Services

$26M

Covered Countermeasure Process FundHealth Resources and Services Administration

$21M

United Mine Workers of America Combined Benefit FundUnited Mine Workers of America Benefit Funds

$19M

Medicare Hearings and AppealsDepartmental Management

$12M

Medicaid and CHIP Payment and Access CommissionLegislative Branch Boards and Commissions

$10M

Consumer Operated and Oriented Plan Program Contingency FundCenters for Medicare and Medicaid Services

$7M

Supplemental Payments to UMWA PlansOffice of Surface Mining Reclamation and Enforcement

$5M

World Trade Center Health Program Fund for Certain WTC Responders at the Pentagon and Shanksville, PennsylvaniaCenters for Disease Control and Prevention

$2M

Rate Review GrantsCenters for Medicare and Medicaid Services

$2M

Medicare Health Information Technology Incentive Payments, Recovery ActCenters for Medicare and Medicaid Services

$2M

How the total adds up

Programs (the 50 accounts above)	$924B
Offsets: premiums, fees, loan repayments, and other collections (11 accounts)	−$674M
Payments between government accounts, net (e.g. general-fund transfers into trust funds, less the matching receipts)	−$387M
Net outlays, matching OMB Historical Table 3.2	$923B

The largest offsets

Transfers from Abandoned Mine Reclamation Fund United Mine Workers of America Benefit Funds	−$398M
HHS Service and Supply Fund Program Support Center	−$113M
Program Management Centers for Medicare and Medicaid Services	−$105M
Office of the National Coordinator for Health Information Technology Departmental Management	−$16M
Contributions, Indian Health Facilities Department of Health and Human Services	−$15M
Rent and Charges for Quarters, Indian Health Service Department of Health and Human Services	−$11M
CDC Working Capital Fund Centers for Disease Control and Prevention	−$6M
Vaccine Injury Compensation Health Resources and Services Administration	−$4M
Consumer Operated and Oriented Plan Direct Loan Program, Downward Reestimate of Subsidies Department of Health and Human Services	−$2M
Transitional Reinsurance Program Centers for Medicare and Medicaid Services	−$2M
Debt Collection Fund Program Support Center	−$2M

All programs, sortable

Sparklines show each program in 2025 dollars, FY2000–2025.

Program	Type	FY2024	FY2025	Change
Medicaid Centers for Medicare and Medicaid Services	Mandatory	$618B	$668B	+8.2%
ACA premium tax credits Internal Revenue Service	Mandatory	$110B	$129B	+17%
CHIP (Children's Health Insurance Program) Centers for Medicare and Medicaid Services	Mandatory	$19.4B	$23.1B	+19%
Health insurance for federal retirees Office of Personnel Management	Mandatory	$15.0B	$16.2B	+7.8%
Department of Defense Medicare-Eligible Retiree Health Care Fund Retiree Health Care	Mandatory	$12.3B	$13.0B	+5.4%
Health Resources and Services Health Resources and Services Administration	Discretionary	$12.3B	$12.7B	+3.5%
Risk Adjustment Program Payments Centers for Medicare and Medicaid Services	Mandatory	$11.5B	$11.2B	−2.0%
CDC-wide Activities and Program Support Centers for Disease Control and Prevention	Discretionary	$11.0B	$10.1B	−7.6%
Substance Abuse and Mental Health Services Administration Substance Abuse and Mental Health Services Administration	Discretionary	$8.89B	$8.34B	−6.2%
Public Health and Social Services Emergency Fund Departmental Management	Discretionary	$14.0B	$8.17B	−41%
Indian Health Services Indian Health Service	Discretionary	$5.32B	$5.23B	−1.8%
Postal Service Retiree Health Benefits Fund Office of Personnel Management	Mandatory	$4.54B	$4.70B	+3.5%
Research, Development, and Procurement Administration for Strategic Preparedness and Response	Discretionary	$505M	$1.53B	+203%
Indian Health Facilities Indian Health Service	Discretionary	$1.78B	$1.33B	−25%
Contract Support Costs Indian Health Service	Discretionary	$1.04B	$1.24B	+20%
Nonrecurring Expenses Fund Departmental Management	Discretionary	$697M	$1.21B	+73%
Retirement Pay and Medical Benefits for Commissioned Officers Program Support Center	Mandatory	$763M	$878M	+15%
Defense Production Act Medical Supplies Enhancement Departmental Management	Mandatory	$1.08B	$759M	−30%
Center for Medicare and Medicaid Innovation Centers for Medicare and Medicaid Services	Mandatory	$628M	$720M	+15%
State Grants and Demonstrations Centers for Medicare and Medicaid Services	Mandatory	$646M	$695M	+7.6%
World Trade Center Health Program Fund Centers for Disease Control and Prevention	Mandatory	$0	$680M	n/a
United Mine Workers of America 1993 Benefit Plan United Mine Workers of America Benefit Funds	Mandatory	$633M	$664M	+4.9%
General Departmental Management Departmental Management	Discretionary	$643M	$614M	−4.5%
Payments for Tribal Leases Indian Health Service	Discretionary	$391M	$542M	+39%
Maternal, Infant, and Early Childhood Home Visiting Programs Health Resources and Services Administration	Mandatory	$0	$476M	n/a
Operations, Preparedness, and Emergency Response Administration for Strategic Preparedness and Response	Discretionary	$167M	$436M	+161%
Abandoned Mine Reclamation Fund Office of Surface Mining Reclamation and Enforcement	Mandatory	$363M	$401M	+10%
Employees and Retired Employees Health Benefits Funds Office of Personnel Management	Mandatory	$1.80B	$319M	−82%
Vaccine Injury Compensation Program Trust Fund Health Resources and Services Administration	Mandatory	$0	$252M	n/a
United Mine Workers of America 1992 Benefit Plan United Mine Workers of America Benefit Funds	Mandatory	$84M	$111M	+32%
Agency for Toxic Substances and Disease Registry, Toxic Substances and Environmental Public Health Centers for Disease Control and Prevention	Discretionary	$103M	$89M	−14%
No Surprises Implementation Fund Departmental Management	Mandatory	$120M	$89M	−26%
Office of Inspector General Office of the Inspector General	Discretionary	$27M	$81M	+200%
Consumer Operated and Oriented Plan Program Account Centers for Medicare and Medicaid Services	Mandatory	$1M	$73M	+7200%
Miscellaneous Trust Funds Program Support Center	Mandatory	$67M	$68M	+1.5%
Child Enrollment Contingency Fund Centers for Medicare and Medicaid Services	Mandatory	$77M	$54M	−30%
Infectious Diseases Rapid Response Reserve Fund Centers for Disease Control and Prevention	Discretionary	$49M	$52M	+6.1%
HHS Accrual Contribution to the Uniformed Services Retiree Health Care Fund Program Support Center	Discretionary	$36M	$38M	+5.6%
Buildings and Facilities Centers for Disease Control and Prevention	Discretionary	$18M	$30M	+67%
Postal Service Health Benefits Program Implementation Fund Office of Personnel Management	Mandatory	$25M	$29M	+16%
Early Retiree Reinsurance Program Centers for Medicare and Medicaid Services	Mandatory	$7M	$26M	+271%
Covered Countermeasure Process Fund Health Resources and Services Administration	Discretionary	$0	$21M	n/a
United Mine Workers of America Combined Benefit Fund United Mine Workers of America Benefit Funds	Mandatory	$13M	$19M	+46%
Medicare Hearings and Appeals Departmental Management	Discretionary	−$31M	$12M	n/a
Medicaid and CHIP Payment and Access Commission Legislative Branch Boards and Commissions	Discretionary	$10M	$10M	+0.0%
Consumer Operated and Oriented Plan Program Contingency Fund Centers for Medicare and Medicaid Services	Mandatory	$0	$7M	n/a
Supplemental Payments to UMWA Plans Office of Surface Mining Reclamation and Enforcement	Mandatory	$1M	$5M	+400%
World Trade Center Health Program Fund for Certain WTC Responders at the Pentagon and Shanksville, Pennsylvania Centers for Disease Control and Prevention	Mandatory	$0	$2M	n/a
Rate Review Grants Centers for Medicare and Medicaid Services	Mandatory	$4M	$2M	−50%
Medicare Health Information Technology Incentive Payments, Recovery Act Centers for Medicare and Medicaid Services	Mandatory	$4M	$2M	−50%

Health care services since 1993

Net outlays in 2025 dollars, fiscal years 1993–2025.

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