The debate over the size and scope of federal spending has raised interest in how federal dollars are spent. This report focuses on federal outlays for major "need-tested" programs—programs targeted toward families and individuals with limited income. The major need-tested programs discussed in this report provide cash, food, housing, and educational and medical assistance to families and individuals with limited financial resources, and they had collective FY2013 federal outlays of $606 billion. These programs represented 17.6% of all federal outlays and 3.7% of the gross domestic product (GDP). This report provides perspective on current federal outlays for these programs, examining historical trends in the outlays as well as showing the Congressional Budget Office's (CBO's) April 2014 baseline budget projections for them. The baseline projections cover the period from FY2014 through FY2024, indicating what spending would be if current law were continued. Additional perspective is provided by showing their trends as a percentage of all federal outlays as well as a percent of GDP. The common feature of need-tested programs is that they provide benefits, services, or funding based on a measure of low financial resources (income and sometimes assets). However, beyond that the programs differ considerably in their target populations, benefits, services, and focus. That is, aid from these programs is not provided to one common group of people or families, nor do these programs address the same purposes. Some address basic needs (food, housing, and medical care); others (e.g., student financial assistance) seek to enable recipients to overcome financial need in order to engage in an activity. Moreover, need-tested programs are not the only programs that benefit low-income persons and families. More universally available social programs—such as the social insurance programs of Social Security, Medicare, and Unemployment Insurance—also benefit low-income persons and families. These programs also tend to be substantially larger (in spending) than need-tested programs. To simplify the analysis, this report focuses on nine of the largest need-tested programs based on federal spending, plus subsidies for health care that were created in the 2010 health reform law, and are available to lower-income families and persons. The need-tested programs discussed in this report are the following: Medicaid/CHIP. Medicaid provides medical assistance to needy families with dependent children and the aged, blind, and disabled who have low incomes. Beginning in 2014, states have the option to expand coverage to able-bodied individuals under age 65 with incomes below 133% of the federal poverty guidelines. A large share of Medicaid expenditures pays for nursing home care for the elderly and disabled. The State Children's Health Insurance Program (CHIP) allows states to cover targeted low-income children with no health insurance in families with income above Medicaid eligibility levels. In addition, when certain conditions are met, states may extend CHIP coverage to pregnant women and parents of Medicaid- and CHIP-eligible children. In FY2013, Medicaid/CHIP outlays of $275 billion accounted for 8.0% of all federal outlays and 1.7% of GDP. The health insurance tax credit , created by the 2010 health care reform law, helps certain individuals and families purchase health insurance beginning in 2014. Under the 2010 law, individuals and families not otherwise covered are able to purchase health insurance from state-based "exchanges." Families with incomes below 400% of the poverty line have their out-of-pocket premium payments capped at a certain percentage of their incomes. The remainder of the premium cost is paid for through an advance-payable, refundable tax credit. The refundable portion of that tax credit is considered a federal outlay. The Supplemental Nutrition Assistance Program (S NAP, formerly known as food stamps) provides low-income families with an income supplement to enable them to purchase a minimal cost, nutritious diet. SNAP is available to all low-income households regardless of their demographic composition, though benefits for able-bodied adults without dependents and who are not working is time-limited and certain noncitizens are excluded. SNAP benefits are uniform nationwide for families of a given size except in Alaska, Hawaii, and the territories. In FY2013, SNAP outlays of $83 billion accounted for 2.4% of all federal outlays and 0.5% of GDP. Student Financial Assistance provides funds (mostly through Pell Grants) to students from low-income families to help meet the cost of post-secondary education. Awards are based on a need analysis that considers both the cost of education and the financial resources of the student's family. In FY2013, outlays for student financial assistance of $34 billion accounted for 1.0% of all federal outlays and 0.2% of GDP. Compensatory Education (Title I-A of the Elementary and Secondary Education Act) provides aid to school districts based on their number and percentage of economically disadvantaged children. The purpose of this aid is to ensure that each child has a high-quality education and reaches, at a minimum, proficiency on state academic achievement standards and assessments under the No Child Left Behind Act. In FY2013, total outlays for compensatory education grants of $16.8 billion accounted for 0.5% of all federal outlays and 0.1% of GDP. Housing Assistance , as categorized for this report, includes federal outlays for project-based rental assistance and tenant-based vouchers (under the Section 8 program); other support for public housing; and housing assistance for the elderly, the disabled, and American Indians. In FY2013, housing assistance outlays of $36 billion accounted for 1.1% of all federal outlays and 0.2% of GDP. The Earned Income Tax Credit (EITC) represents the refundable portion of the earned income tax credit. It provides an earnings supplement for low-wage earners, with the size of the credit dependent on family type and earnings. The bulk of EITC dollars was historically delivered through tax refund checks and goes to families with children. Beginning in 2012, all "advance payments" of EITC benefits were ended, and all refundable EITC dollars are paid through refund checks. In FY2013, EITC outlays of $57 billion accounted for 1.7% of all federal outlays and 0.4% of GDP. The Additional Child Tax Credit (ACTC) represents the refundable portion of the child tax credit. It assists eligible parents of children who have earned income above a certain threshold but whose tax liability is too small to fully benefit from the regular nonrefundable child tax credit. It is delivered to families through refund checks when they file their taxes. In FY2013, ACTC outlays of $22 billion accounted for 0.6% of all federal outlays and 0.1% of GDP. Supplemental Security Income (SSI) provides a federally funded cash income floor for low-income persons or couples who are aged, blind, or disabled. Federal SSI benefits are based on uniform nationwide eligibility and benefit rules, and they are paid with federal funds. States may supplement SSI with their own funds. In FY2013, SSI outlays of $57 billion accounted for 1.6% of all federal outlays and 0.3% of GDP. Family Support, as categorized for this report, includes outlays for the Temporary Assistance for Needy Families (TANF) block grant, the Child Support Enforcement (CSE) program, and federal grants to help support state child care subsidy programs. In FY2013, family support outlays of $26 billion accounted for 0.8% of all federal outlays and 0.2% of GDP. This report focuses only on federal outlays. A number of programs (Medicaid, SNAP, housing assistance, and family support) are actually administered at the state or local level. States also contribute financially to Medicaid, SNAP (administrative and employment and training costs), and family support. Further, the bulk of financing for elementary and secondary education represents state and local dollars. Additionally, this report focuses on programs classified as "major" by their current spending level. This focus might leave out some programs that historically comprised a greater share of aid to low-income persons. For example, employment and training programs had much higher spending levels in the 1970s than they do today. Excluding such programs has the effect of somewhat depressing historical spending levels (in the late 1970s) and overstating growth since then. It also leaves out the part of the story regarding low-income assistance: training and employment, particularly public service employment in the late 1970s, were once a greater part of low-income aid. Federal outlays for low-income assistance have generally increased over the past five decades. In total, spending for low-income assistance in inflation-adjusted terms has been higher at the end of each decade. Though there have been some declines in spending immediately following recessions, the long-term trend in federal outlays for low-income assistance is one of increasing spending during both economic downturns and periods of economic growth. Figure 1 shows federal outlays for the major low-income assistance programs in inflation-adjusted terms for FY1962 through FY2013, and shows CBO-projected outlays under current law for FY2014 through FY2024. The figure shows several periods of pronounced growth, with the most recent occurring from FY2007 through FY2011. This represents spending, both automatic (through increased enrollment) as well as legislated (e.g., benefit and funding increases through the American Recovery and Reinvestment Act of 2009 (ARRA, P.L. 111-5 )), in response to the deep recession from 2007 to 2009.