Major mandatory health care programs are now on track to outpace the costs of Social Security for the next decade. Provisions of the Affordable Care Act (ACA) are responsible for the majority of the new costs of major health care programs. By 2026, these health programs and Social Security alone will cost taxpayers $3.453 trillion annually, or about 83 percent of mandatory spending. Without tackling the costs of these programs, we cannot constrain the growth of mandatory spending or prevent the upcoming debt crisis.