It's been an action-packed week on Capitol Hill. First, lawmakers approved a continuing resolution to keep the government open through mid-November. Then, eight House Republicans united with Democrats to depose Rep. Kevin McCarthy (R-CA) as speaker.

The chaos in the House will make dealing with our nation's spending crisis even more difficult. The national debt recently passed $33 trillion . The government's cost of borrowing, as measured by the 10-year Treasury yield, has reached a 16-year high . Interest costs are the fastest-growing "program" in the federal budget, according to the Peter G. Peterson Foundation.

Lawmakers must tackle the main drivers of out-of-control federal spending. That means reining in Medicare and Medicaid.

Enrollment in Medicaid has skyrocketed, largely due to Obamacare's Medicaid expansion and a pandemic-era prohibition on disenrolling people from the program. As of June 2023, Medicaid and the related Children's Health Insurance Program covered nearly 93 million people — a 60% increase relative to the pre-Obamacare figure .

Enrollment today is slightly lower. At least 7.8 million people have been removed from Medicaid as of Oct. 2, as states resumed auditing their rolls to ensure eligibility.

This disenrollment push won't do much to change the cost trajectory of the program. By 2030, the Centers for Medicare and Medicaid Services projects that Medicaid spending will exceed $1 trillion , up from roughly $800 billion today. Already, Medicaid accounts for 9% of federal spending .

Spending on Medicare, meanwhile, is expected to eclipse $1 trillion for the first time this year. Costs are only going up as the population ages. CMS projects that Medicare's bill will pass $1.7 trillion in 2030 . The program represented 12% of the federal budget in 2022 — and will jump to 18% by 2053.

There are plenty of ways to find savings in these programs.

Lawmakers could realign Medicaid with its original mission, caring for low-income and disabled people, by instituting work requirements for able-bodied adults.

They could also give federal Medicaid dollars to the states via block grants so they do not have a perverse incentive to expand their programs to attract more federal money. Under the status quo, each dollar a state spends on Medicaid attracts more than one dollar in federal funds.

On the Medicare side, lawmakers can consider raising the age at which seniors become eligible in order to reflect the increase in life expectancy people have enjoyed since the program was created nearly 60 years ago. They can also introduce more means-testing and provide seniors vouchers to purchase insurance on the private market. Injecting more competition into the market for seniors' health dollars is a surefire way to lower costs and improve quality.

Each of these options would meaningfully reduce government spending — long past mid-November.

Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is  False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on Twitter @sallypipes .