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In fiscal year 2020—assuming the projections prove true—the budget will record the first $1 trillion deficit since the financial crisis of the last decade. US and world financial markets likely will fail to recognize the debt problem until the process of deterioration has gone well past the point of no return. Now is the time for Congress to act. This in-depth report examines factors that contribute to debt and describes steps needed to put the US back on the path to fiscal health.