Current federal commitments to health care are on a course to consume an ever larger share of the budget. New subsidies bring two forms of risk to the federal budget which could either exacerbate or moderate this trend. First, there is the financial risk that can be anticipated at the time health care reform happens. Second, there is the risk that things will turn out differently than expected.

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Iranian workers walk past a destroyed residential building due to Israeli attacks in Tehran, Iran, on June 13, 2025. (Morteza Nikoubazl via Getty Images)