The American Action Forum provided a new estimate of the expected cost of health insurance subsidies available to individuals through the new health insurance exchanges. According to the report's authors, Douglas Holtz-Eakin and Michael Ramlet, the Congressional Budget Office's figures now show that the subsidies will cost $574 billion between 2012 and 2019, which is roughly $112 billion more than the original estimate. "The ACA health insurance subsidies are the most significant expansion of entitlements since the 1960s. In light of the precarious fiscal outlook for the federal government, its cost is a central concern to policymakers and taxpayers alike.... Unfortunately, there are grounds to anticipate further growth in the cost of the entitlement due to the risks of faster than expected health care inflation, slow growth in incomes, and the potential for less employer-sponsored insurance in the future," the report says.