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Federal Medicaid Spending Through State Directed Payments Nears $100 Billion Annually Across 41 States, With New Limits Set to Reduce Funding to States

Jun 15, 2026

News Release

Forty states and DC currently receive $93 billion in annual federal Medicaid spending through state directed payments (SDPs) and may be at risk due to forthcoming limits on these payments, according to new KFF estimates. Annual federal spending on SDPs is highest in California (an estimated $10.6 billion)—followed by Texas ($6.3 billion), North Carolina ($5.2 billion), and Illinois ($5.1 billion).

Spending on Medicaid State Directed Payments Before New Limits Take Effect

Jun 15, 2026

Issue Brief

This issue brief analyzes Medicaid spending by state on SDPs that require prior CMS approval to better understand the use of SDPs before new limits in the reconciliation law take effect.

U.S. Foreign Aid Freeze & Dissolution of USAID: Timeline of Events

Jun 11, 2026

Feature

This timeline provides a detailed overview of actions, including counter-actions, related to the administration’s efforts to freeze all U.S. foreign aid and dissolve the U.S. Agency for International Development (USAID).

Overview of President Trump’s Executive Actions on Global Health

Jun 11, 2026

Fact Sheet

This guide provides an overview of executive orders and other executive actions made by the Trump Administration since January 21, 2025 that directly address or affect U.S. global health efforts. This resource identifies each executive action, describes its purpose and actions taken, and outlines the implications and what happens next for each. The resource will be updated as needed.

How Medicare Advantage Rebates Disadvantage Medicare’s Stand-Alone Drug Plan Market

Jun 11, 2026

Issue Brief

The private plans that offer the Medicare Part D benefit - stand-alone drug plans and Medicare Advantage drug plans - are increasingly are competing on uneven terms, in part because the payment system for Medicare Advantage plans enables them to lower Part D premiums or reduce Part D cost sharing, making drug coverage from Medicare Advantage plans appear considerably cheaper, or even premium-free, to the beneficiary. This brief discusses the growing instability of the Part…

Medicare Part D Enrollment, Premiums, and Cost Sharing in 2026

Jun 11, 2026

Issue Brief

The Medicare Part D program provides an outpatient prescription drug benefit to 56 million older adults and people with long-term disabilities in Medicare who enroll in private plans. This brief analyzes Medicare Part D enrollment, premiums, and cost sharing in 2026 and trends over time, based on data from the Centers for Medicare & Medicaid Services (CMS).

The Number of ACA Marketplace Insurers Per State Dropped From a Record High in 2025. Chart shows the average number of insurers in the ACA Marketplace per state and plan selections, 2014 - 2026

How Has Insurer Participation in the ACA Marketplaces Changed in 2026?

Jun 11, 2026

Issue Brief

This brief features maps showing how insurer participation has changed at the state and county level from 2025 to 2026 as well as insight into the number of issuers offering plans at specific metal levels.

Rare or Unverified Outcomes Shape Vaccine Safety and Gender Care Debates — The Monitor

Jun 11, 2026

Feature

Two recent federal actions, including a memo about alleged COVID-19 vaccine deaths and settlements creating a “detransition clinic,” show how official actions can present uncertain or uncommon outcomes as representative and lend credibility to narratives that go beyond what evidence supports.

House Appropriations Committee Releases FY 2027 Labor, Health and Human Services, Education, and Related Agencies (Labor HHS) Appropriations Bill & Accompanying Report

Jun 10, 2026

Fact Sheet

This budget summary provides an analysis of global health funding amounts provided in the FY 2027 House Labor, Health and Human Services, Education, and Related Agencies (Labor HHS) appropriations bill and accompanying report.

Analysis of U.S. and Global Fund Funding Reductions in MOU Countries

Jun 10, 2026

Issue Brief

This analysis assesses the magnitude of combined U.S. and Global Fund funding cuts between 2026 and 2029, relative to prior funding levels, in 29 countries with signed MOUs and available data.

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