The CBO presented its updated estimates on the Affordable Care Act’s costs and impact on insurance coverage in a 15-page appendix. It estimated that the total net cost of the insurance coverage provisions of the law would be $1.35 trillion over 10 years, from 2016 through 2025. This net cost includes gross costs of $1.993 trillion, which includes spending on subsidies for insurance obtained through the exchanges, tax credits to small businesses and expanded Medicaid coverage, minus revenues of $643 billion, which includes penalty payments from those who don’t obtain insurance and employers who don’t provide it.