Coverage

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.

To understand the impact of Medicaid work requirements included in the budget reconciliation bill being debated in Congress, KFF has undertaken two different analyses using different data sources. Using 2023 data from the Survey of Income and Program Participation, this analysis looks at the share of adults who work at least 80 hours per month, the reasons some do not, and how consistently individuals meet the requirement over a six-month period.

Through regulations and the House budget reconciliation bill, significant changes are being considered by Congress and the Trump Administration for how the Affordable Care Act’s health insurance Marketplaces would work. To examine how these changes could reshape the ACA’s Marketplaces, KFF held a virtual briefing on June 11 featuring leaders from two state-based Marketplaces to get perspectives from the field.

This brief uses 2021 Medicaid claims data to examine utilization among Medicaid expansion adults and estimate how much cost sharing these enrollees could be required to pay under the new requirement if all states imposed the maximum cost sharing amounts. This is an illustrative analysis intended to describe which enrollees may be subject to the most cost sharing under the new provisions rather than estimate exactly what expansion enrollees may actually pay.

Proposed changes in eligibility rules in both SNAP and Medicaid may jeopardize some people’s access to both adequate food and health care if various provisions of the bill take effect, in part because there is a significant overlap in eligibility requirements for Medicaid and SNAP across states. Four in 10 (40%) Medicaid enrollees receive SNAP benefits.

On June 27, 2025, the U.S. Supreme Court issued its opinion on Kennedy v. Braidwood Management, ruling that the ACA requirement that most private insurers and Medicaid expansion programs to cover preventive services recommended by the United States Preventive Services Preventive Task Force (USPSTF) with no cost-sharing is constitutional.

House Republicans have passed a reconciliation package (the “One Big Beautiful Bill Act”) that would make significant changes to Medicaid and the Affordable Care Act (ACA) Marketplaces and increase the number of people without health insurance by an estimated 10.9 million. This analysis estimates state-level increases in the number of uninsured people due to this legislation, along with other changes to the Marketplace, including the expiration of the enhanced premium tax credits.

To improve the affordability of abortion services, many states have passed laws that require state-regulated plans to cover the full cost of abortion services for their enrollees. This data note documents the costs associated with abortion care in private plans. Also, KFF analyzes how out of pocket spending has been affected by state laws that require full coverage of abortion services.

This issue brief discusses key changes to immigration policies that may take place under the second Trump administration based on his previous record and campaign statements, and their implications.

This brief provides an overview of DACA and who DACA recipients are and provides estimates of health coverage, work status, and income among individuals who meet eligibility criteria for DACA.