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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).

Quick Takes: Timely insights and analysis from KFF staff

The VP Debate May Focus on the “Working Class,” But Will They Discuss Medicaid?

Sep 30, 2024

Quick Insights

If Tuesday’s vice presidential debate turns to Medicaid and work requirements, the policy trade-offs will be about working people’s access to Medicaid coverage – not about increasing work.

Housing Affordability, Adequacy, and Access to the Internet in Homes of Medicaid Enrollees

Sep 22, 2021

Issue Brief

The COVID-19 pandemic and the ensuing economic disruption have drawn more attention to longstanding issues related to housing and internet access and how these issues can impact health. As the primary source of health insurance for low-income populations, Medicaid covers a considerable share of people living in homes that are unaffordable, inadequate, or have limited access to the internet. This brief examines housing adequacy, affordability, and internet access within the homes of Medicaid enrollees using…

Analysis Examines How States Can Use Medicaid Programs to Facilitate Access to Vaccines for Low-Income Children

Nov 19, 2021

News Release

As states expand COVID-19 vaccination efforts to reach newly eligible children ages 5 to 11, a new KFF analysis highlights several tools state Medicaid programs have at their disposal to increase access to, and take up of, vaccines among lower-income children. Among the key findings: States can request Medicaid administrative federal matching funds for state-funded monetary incentives to encourage uptake of the vaccine. In recent months, several states reported activities and incentives within contracted Medicaid…

KFF Dashboard: Progress Toward Global Tuberculosis Targets in USAID TB Countries

Nov 25, 2025

Interactive

This dashboard monitors the status of USAID tuberculosis (TB) priority countries’ progress toward global TB targets. It includes data for more than 20 countries in which USAID’s bilateral TB program currently carries out its efforts.

Family Planning Services for Low-Income Women: The Role of Public Programs

Dec 1, 2025

Issue Brief

This brief explains the major sources of public financing for family planning care, related policies, and their role financing services for low-income women.

5 Key Facts About Medicaid Coverage for Adults with Chronic Conditions

Apr 10, 2025

Issue Brief

Nearly three in four adults enrolled in Medicaid have one or more chronic conditions. Medicaid spending doubles for adults with 1-2 chronic conditions and quadruples for those with 3 or more chronic conditions. Low or no out-of-pocket costs for prescription medications in the Medicaid program help adults with chronic conditions avoid cost-related rationing or delays in prescription access. Uninsured adults were 2.5 times more likely than Medicaid-enrolled or privately insured adults to report skipping or…

Less than 1% of Total Medicaid Spending Goes to Emergency Care for Noncitizen Immigrants

Oct 4, 2024

Quick Insights

Despite claims that immigrants are accessing and draining public benefits, less than 1% of Medicaid’s budget is spent on hospital emergency care for noncitizen immigrants.

A Closer Look at Rape and Incest Exceptions in States with Abortion Bans and Early Gestational Restrictions

Aug 7, 2024

Policy Watch

Ten of the 21 states with abortion bans or gestational limits do not have an exception for pregnancies resulting from sexual assault. In the 11 states with rape and incest exceptions, the details and fine print make can make access to abortion care unattainable for pregnant survivors of sexual assault. Law enforcement reporting requirements, early pregnancy gestational limits, and the lack of provider availability present major barriers to abortion access, even when the state has…

Medicare Open Enrollment and Coverage Options: Key Questions and Answers

Oct 9, 2026

Issue Brief

Each year, Medicare beneficiaries have an opportunity to make changes to how they receive their Medicare coverage during the nearly 8-week annual open enrollment period. This brief answers key questions about the Medicare open enrollment period and Medicare coverage options.

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