; termination of program (1) Determination Not later than July 1, 2026, the Chief Actuary of the Centers for Medicare & Medicaid Services shall determine whether the Program has resulted in an increase in total expenditures under this title with respect to the period beginning on January 1, 2021, and ending on December 31, 2025, compared to what such expenditures would have been during such period had the Program not been in operation. (2) Termination If the Chief Actuary makes a determination under paragraph (1) that the Program has resulted in an increase in total expenditures under this title, the Secretary shall terminate the Program as of January 1 of the first year beginning after such determination. .