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Fact check: What did the Congressional Budget Office conclude about the $1.5 trillion healthcare cost claim for the 2024–2025 continuing resolution?
Executive summary
The Congressional Budget Office did not validate a one-line claim that the 2024–2025 continuing resolution would add $1.5 trillion in health-care costs to that single-year budget; CBO’s formal analyses instead show specific provisions and longer-term policy changes with much smaller, time-limited budget effects and separate, multi-year estimates for different policies. A careful reading shows the $1.5 trillion figure conflates distinct CBO estimates across different proposals and multi-year windows rather than reflecting a single CBO conclusion about the CR for FY2024–FY2025 [1] [2] [3].
1. The claim that the CR adds $1.5 trillion — where that number comes from and why it’s misleading
Multiple documents and summaries circulating about the FY2025 continuing resolution and related health provisions aggregate different CBO estimates that apply to different policies and timeframes, producing large headline numbers that do not describe a single-year CR cost. CBO’s FY2025 scoring of the Full-Year Continuing Appropriations and Extensions Act set overall discretionary funding at about $1.6 trillion total for FY2025 (with $893 billion defense, $708 billion non-defense) and estimated a modest net deficit impact through 2034, not a $1.5 trillion one-year healthcare spike [1] [3]. Separately, CBO has produced multi-year estimates—for example, projecting the fiscal impact of making premium tax credits permanent across a 2026–2035 window—but those multi-year tallies cannot be read as an immediate FY2024–FY2025 CR cost [2]. Presenting an aggregated $1.5 trillion as the CR’s healthcare cost therefore mixes apples and oranges: different statutory changes, different baselines, and different scoring windows are bundled into one figure that CBO did not present as the CR’s single-year cost [1].
2. What CBO did say specifically about the FY2025 continuing resolution and its budget effects
In CBO’s scoring of the CR and the Full-Year Continuing Appropriations and Extensions Act, the agency estimated total discretionary funding levels and a small net deficit impact through the budget window; the agency’s published estimate described net impacts on discretionary outlays, defense and nondefense appropriations, and extended health-related policies, concluding an overall net deficit effect measured over multiple years rather than an immediate $1.5 trillion increase in healthcare spending for 2024–2025 [1] [3]. The publicly released CBO table for that bill focused on aggregate appropriations totals and the bill’s net effect (for example, an estimated net deficit effect on the order of billions across the budget window), not a single-year, one-category $1.5 trillion charge to health programs in the CR [3]. That distinction matters because CBO’s formal role is to score enacted provisions against a baseline and across the years specified; CBO did not produce a single-year, CR-specific $1.5 trillion healthcare cost estimate in its FY2025 CR analyses [1].
3. Where the $1.5 trillion figure does appear in CBO work — and how to interpret it
CBO’s analytic output does include $1.5 trillion–scale numbers, but in different contexts. A CBO working paper on single-payer options illustrated scenarios where federal subsidies might rise by roughly $1.5 trillion to $3.0 trillion under broad, long-term structural reforms to national coverage—these are illustrative, multi-year projections about alternate systems, not scores of a FY2025 CR [4]. Likewise, CBO’s estimates of making certain Affordable Care Act subsidies permanent produce hundreds of billions in deficit increases across a multi-year window (for example, an estimate of $349.8 billion for premium tax credit expansion from 2026–2035), which can be aggregated into larger totals depending on the span and policies included [2]. Those figures are contextual and policy-specific: they show the fiscal implications of policy choices over a decade, not a single continuing resolution’s immediate cost for one fiscal year [4] [2].
4. How partisan messaging and aggregation choices create confusion
Advocates and opponents of the CR or of specific health provisions often aggregate CBO numbers from distinct reports and timeframes to produce large, attention-grabbing totals. This practice can present credible CBO outputs in misleading ways: CBO provides policy-specific, time-bound estimates, but external communicators sometimes combine multiple CBO numbers—multi-year estimates, illustrative analyses, and separate pieces of legislation—into a single headline. The resulting claim that the CR alone imposes a $1.5 trillion health cost conflates policy permanence, scoring windows, and different legislative texts, and therefore does not reflect a discrete CBO conclusion about the FY2024–FY2025 CR [1] [2] [4].
5. Big-picture takeaway and how to read future claims responsibly
When encountering headline totals like $1.5 trillion, scrutinize the CBO citation: does it score the specific bill and the specific fiscal year, or is it a multi-year projection of separate policy changes? CBO’s formal scoring of the FY2025 continuing resolution produced detailed, smaller-scale net effects and baseline-adjusted numbers for discretionary funding and certain health policy extensions, not a single-year $1.5 trillion healthcare cost. For accurate interpretation, prefer the original CBO documents and their time windows and treat aggregated external totals with caution until they are traced back to which CBO estimate and which years they actually cover [1] [3] [2].