This brief examines the latest Congressional Budget Office (CBO) projections for federal Medicaid and CHIP spending over the 2014-2024 period. CBO’s budget projections, also known as “baseline” projections, reflect CBO’s best judgment about how the economy and other factors will affect federal revenues and spending under existing laws. The brief also examines CBO estimates of the coverage effects of the Affordable Care Act (ACA) on Medicaid and CHIP enrollment and spending. Understanding the CBO baseline estimates is important because they are the basis to evaluate the federal cost and coverage implications of proposed federal policy changes.