Congress could unlock tens of billions of dollars in federal government cost savings and financial benefits, reduce waste, and improve government services by acting on hundreds of recommendations that the Government Accountability Office (GAO) has made over the past quarter-century.
Some of those recommendations involve federal agency IT improvements, according to a new GAO report.
In the report released on May 12, GAO said lawmakers still have 277 open “matters for congressional consideration” – recommendations that the watchdog agency directed to Congress rather than executive branch agencies – that, if enacted, could strengthen program effectiveness across the federal government.
GAO has issued more than 1,150 such recommendations since 2000, and nearly 80% have been advanced through congressional action or other developments.
But GAO emphasized that the remaining recommendations continue to present significant opportunities for savings and operational improvements for the government.
“Action to address certain open matters can produce tens of billions of dollars in future financial savings,” the report says.
Of the 277 outstanding recommendations, GAO identified 53 that could generate measurable financial benefits, including 13 with the potential to save $1 billion or more each.
The largest savings opportunity identified by GAO involves the Centers for Medicare & Medicaid Services’ payment reform. GAO reiterated a longstanding recommendation that Congress direct the U.S. Department of Health and Human Services to equalize Medicare reimbursement rates for similar services provided in different health care settings, such as physician offices and hospital outpatient departments.
That change, first recommended in a 2016 report on hospital-physician consolidation, could save approximately $156.9 billion over 10 years, with the savings returned to the Medicare program, GAO said.
Another major opportunity involves FirstNet, the nationwide public-safety broadband network used by emergency responders. GAO said congressional action to reauthorize FirstNet and clarify its statutory and contractual responsibilities could save an estimated $15 billion over 15 years.
GAO also highlighted a recommendation dating to its 2014 annual duplication report that Congress require the Social Security Administration to offset disability insurance benefits for individuals who receive unemployment insurance during the same period. The agency estimated that the change could save $2.2 billion over a decade.
Beyond direct budget reductions, GAO said many of the open recommendations could improve agency performance and help the federal government confront emerging challenges.
One example is a July 2025 recommendation calling on Congress to require major agencies to develop IT modernization plans to reduce the risk of costly program failures, cybersecurity vulnerabilities, and operational disruptions.
Some of the recommendations are already reflected in pending legislation. As of February 2026, bills introduced in the 118th and 119th Congresses would have fully or partially addressed 103 of the 277 open matters, or about 37%.
GAO said 21 of those matters are tied to legislation that could collectively yield tens of billions of dollars in financial benefits if enacted.
The recommendations span a broad range of policy areas, including defense, energy, health care, economic development, information technology, and federal financial management. Of the 277 open matters, 123 – approximately 44% – have been outstanding for five years or less, while the oldest has remained unresolved for nearly 25 years, concerning federal oversight of food safety, an issue on the GAO’s High-Risk List.