The US Acid Rain Program (Title IV of the 1990 Clean Air Act Amendments) has achieved substantial reductions in emissions of sulfur dioxide (SO2) and nitrogen oxides (NOx) from power plants in the United States. We compare new estimates of the benefits and costs of Title IV to those made in 1990. Important changes in our understanding of and ability to quantify the benefits of Title IV have occurred. Benefits to human health now take a much higher profile because the contribution of SO2 and NOx emissions to the formation of fine particulate (PM2.5) is substantial, and evidence of the harmful human health effects of PM2.5 has emerged in the last 15 years. New estimates of the health benefits of PM2.5 reductions are the largest category of quantified health and environmental benefits and total over 100 billion US dollars annually for 2010 when the program is expected to be fully implemented. Although important uncertainties exist in any specific estimate of the benefits, even if the estimates were calculated using more limiting assumptions and interpretations of the literature they would still substantially exceed the costs. Estimates of annualized costs for 2010 are about 3 billion US dollars, which is less than half of what was estimated in 1990. Research since 1990 also suggests that environmental problems associated with acid deposition and nitrogen deposition are more challenging to resolve than originally thought and will require larger reductions in emissions to reverse. The greater than expected benefits to human health, the greater vulnerability of natural resources and ecosystems, and the lower than expected costs all point to the conclusion that further reductions in SO2 and NOx emissions from power plants beyond those currently required by Title IV are warranted.