- CBO: Medicaid Spending Falls 35 Percent In 20 Years Under Senate Health Bill Politico by Rachana Pradhan - The drop-off stems from stricter limits Republicans want to enact beginning in 2025 to control the entitlement's growth. Under the Senate bill, federal Medicaid outlays would be 26 percent less in 2026 compared to current law. The gap widens to 35 percent in 2036. The drop-off stems from stricter limits Republicans want to enact beginning in 2025 to control the entitlement's growth. Under the Senate bill, federal Medicaid outlays would be 26 percent less in 2026 compared to current law. The gap widens to 35 percent in 2036.