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Section 1115 Medicaid waivers can allow states to test new approaches in Medicaid that differ from what is required by federal law. This page tracks approved and pending waiver provisions (including expansions and restrictions) related to eligibility, benefits, and social determinants of health and other delivery system reforms.

On May 22, the House passed a budget reconciliation bill that includes significant changes to the Medicaid program. On June 16, the Senate Finance committee released proposed reconciliation language with some substantive changes to the Medicaid work requirement provisions, but this language may change as the Senate debates the bill. This issue brief provides an overview of the Medicaid work requirement provisions.

This page displays an interactive map of the current status of state decisions on the Affordable Care Act’s Medicaid expansion. Additional Medicaid expansion resources are listed (with links) below the map.

This analysis allocates the CBO’s estimated reduction in federal spending in the Senate reconciliation bill across states based on KFF’s state-level data and where possible, prior modeling work; and shows the federal spending reductions relative to KFF’s projections of federal spending by state under current law.

This brief describes key challenges that Medicaid work requirements may pose for adults with mental health or substance use disorders. In May, the House passed a budget reconciliation bill that includes national Medicaid work requirements for adults in the Affordable Care Act (ACA) expansion group.

On May 18, the House Budget Committee advanced a budget reconciliation bill that includes significant changes to the Medicaid program. As anticipated, Medicaid work requirement provisions are included and preliminary estimates released by the Congressional Budget Office (CBO) show that this provision would reduce federal spending by $280 billion over ten years, nearly half of all estimated Medicaid savings in the bill. The provisions raise many operational and implementation questions, particularly considering the experience of Arkansas and Georgia with implementing work requirements through waivers.

The Congressional Budget Office’s (CBO) latest estimate shows that the One Big Beautiful Bill would reduce federal Medicaid spending by $793 and that the Medicaid provisions would increase the number of uninsured people by 7.8 million. Previous CBO estimates show that 10.3 million fewer people would be enrolled in Medicaid in 2034. Building on prior KFF analysis, this analysis allocates these estimated federal spending reductions and enrollment losses across the states.

Amid debates to limit federal Medicaid support, this brief presents five facts to know about Medicaid’s role for family planning. 

Recent actions from the Trump administration could signal limits to curtail Medicaid waivers related to social determinants of health and to limit waiver financing tools and flexibility. Two major changes demonstrate this shift: (1) rescinding Biden-era guidance on covering health-related social needs (HRSN) services, and (2) phasing out federal funding for “Designated State Health Programs” (DSHP) in waivers.

This issue brief examines Medicaid expansion enrollment and Medicaid spending in expansion and non-expansion states and describes the characteristics of adults covered by the Medicaid expansion.