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Medicare is currently running off the accumulated Treasuries in the so-called "lock box" (which isn't, of course.) This is why its full impact doesn't show up in the budget deficit; they're spending accumulated capital in large part, basically.

Ok, this is the part I'm missing. The MTR says the HI fund spent $306.6b and took in $308.2b last year, and has $200.4b left in the fund. But it also says it's expected to run out in 2026. A $1.6 deficit over 7 years does not consume $200, even if cost rises exponentially, so obviously I'm missing a number in that equation. The SMI fund had $104.3 sitting in it but it also took 74% ($319.98) of its revenue from the general fund, which sounds like it comes straight from the federal budget, and nobody seems worried about that one so I assume it's not the problem.