In light of recent economic trends and the most recent Congressional Budget Office projections (CBO 2024), we offer new perspectives on the medium- and long-term fiscal outlook, updating our previous work, most recently in Auerbach and Gale (2023a and 2023b). The basic story is familiar. Low revenues, coupled with rising outlays on health-related programs and Social Security, drive permanent, rising primary deficits as a share of the economy. Net interest payments also rise substantially relative to GDP due to high pre-existing debt, rising primary deficits, and gradually increasing interest rates. Unified deficits ... (full story)