KFF designs, conducts and analyzes original public opinion and survey research on Americans’ attitudes, knowledge, and experiences with the health care system to help amplify the public’s voice in major national debates.
KFF's annual Medicaid budget survey tracks national enrollment and spending trends as well as state policy actions in key areas, including related to delivery systems, reimbursement rates and provider taxes, benefits, and pharmacy policy. The annual survey is conducted at the beginning of each state fiscal year, and the results have typically been published every fall. Mid-fiscal year surveys were conducted in select years.
Annual and mid-year reports published since 2016 can be found below. Older reports have been archived here. The survey instrument and additional methods information are included in each published report.
The annual survey is conducted by KFF and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD).
This issue brief uses data from KFF’s 2025-2026 survey of Medicaid directors to describe states’ current provider taxes, explore how the 2025 reconciliation law changed the federal rules governing provider taxes, and summarize potential impacts of the changes across states.
This brief analyzes Medicaid enrollment and spending trends for FY 2025 and FY 2026, based on data provided by state Medicaid directors as part of the 25th annual survey of Medicaid directors.
As states completed the “unwinding” of pandemic-era continuous coverage, Medicaid enrollment fell 7.6% in FY 2025 and is expected to be largely flat in FY 2026. At the same time, total Medicaid spending grew by 8.6% in FY 2025 and is expected to grow by 7.9% in FY 2026.
This brief analyzes Medicaid enrollment and spending trends for FY 2024 and FY 2025, based on data provided by state Medicaid directors as part of the 24th annual survey of Medicaid directors.
This report highlights certain policies in place in state Medicaid programs in FY 2024 and policy changes implemented or planned for FY 2025, which began on July 1, 2024 for most states.
On November 14, 2023 KFF and the National Association of Medicaid Directors (NAMD) held a web briefing to discuss the latest trends in Medicaid enrollment and spending and highlight key Medicaid policy changes that states implemented in state FY 2023 or plan to implement in FY 2024.
This issue brief analyzes Medicaid enrollment and spending trends for FY 2023 and FY 2024, based on data provided by state Medicaid directors as part of the 23rd annual survey of Medicaid directors in states and the District of Columbia.
This report highlights certain policies in place in state Medicaid programs in FY 2023 and policy changes implemented or planned for FY 2024, which began on July 1, 2023 for most states.