CBO Projects Medicaid Enrollment and Spending Decline Through 2036 Under Reconciliation Law
The Congressional Budget Office's February 2026 projections show significant reductions in Medicaid enrollment and federal spending over the next decade following passage of the 2025 reconciliation law. The analysis compares current projections to pre-reconciliation baselines, quantifying the impact of policy changes including eligibility restrictions, state flexibility provisions, and federal funding modifications. CBO accounts for both legislative changes and updated economic assumptions in projecting enrollment trends and program costs through 2036. The projections provide the first comprehensive federal assessment of how reconciliation provisions will reshape Medicaid program size and federal financial participation.
These projections establish the federal baseline for managed care organizations to model membership losses, revenue impacts, and state contract modifications as reconciliation provisions phase in.
Managed Care · Finance
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