Medicaid Watch

Federal Medicaid Spending Reductions and Enrollment Loss Across the States

The Congressional Budget Office’s (CBO) latest estimate shows that the One Big Beautiful Bill would reduce federal Medicaid spending by $793 billion. Previous CBO estimates show that 10.3 million fewer people would be enrolled in Medicaid in 2034, representing 12% of projected enrollment for that year. Washington and Virginia could see the largest percentage drops in Medicaid enrollment, with their rolls falling by 26% and 21%, respectively.
How Will the 2025 Reconciliation Bill Affect the Uninsured Rate in Each State?

CBO projects the One Big Beautiful Bill would increase the number of people without health insurance by 10.9 million and 16 million more when the expected expiration of the ACA’s enhanced premium tax credits is included. About half (48%) of the 16 million more people who would be uninsured in this scenario live in Florida (2.3M), Texas (1.9M), California (1.8M), New York (920k), and Georgia (750k).

Understanding Medicaid

5 Facts: Medicaid and Immigrants
Confusion persists about immigrants’ eligibility for federal programs. This brief helps readers understand how current Medicaid policy affects immigrants as well as the potential impacts of policy changes under the Trump administration.
5 Facts: Medicaid and Rural Areas
Approximately 66 million people live in rural areas – about 20% of the U.S. population. Nearly 1 in 4 of them have Medicaid, a higher share than in urban areas (24% vs 21%).
5 Facts: Nursing Facilities and Medicaid
Amid debates about federal Medicaid cuts, which could cause states to lower Medicaid reimbursement rates for nursing facilities, this brief explains how Medicaid supports nursing facilities and the people living in them.
5 Facts: Medicaid and Hospitals
Absorbing reductions in Medicaid spending could be challenging for hospitals, particularly for those that are financially vulnerable. This brief provides data on the reach of Medicaid across hospitals, patients, and charity care.
5 Facts: Medicaid and Provider Taxes
All states except Alaska cover some state Medicaid costs with taxes on health care providers. This brief uses data from KFF’s 2024-2025 survey of Medicaid directors to describe current practices and the federal rules governing them.