A View of Medicaid Today and a Look Ahead: Balancing Access, Budgets and Upcoming Changes
This report highlights key policy priorities and issues state Medicaid programs focused on in FY 2025 and are prioritizing in FY 2026.
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State Health Facts is a KFF project that provides free, up-to-date, and easy-to-use health data for all 50 states, the District of Columbia, and the United States. It offers data on specific types of health insurance coverage, including employer-sponsored, Medicaid, Medicare, as well as people who are uninsured by demographic characteristics, including age, race/ethnicity, work status, gender, and income. There are also data on health insurance status for a state's population overall and broken down by age, gender, and income.
This report highlights key policy priorities and issues state Medicaid programs focused on in FY 2025 and are prioritizing in FY 2026.
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 poll finds that public support remains high for extending the enhanced ACA tax credits set to expire at the end of the year. Three quarters of the public favor of extending them, though support among Republicans has dipped since September. Most Democrats want a Congressional budget deal to include an extension of the tax credits.
To better understand how states are preparing for Medicaid work requirements, states were asked to discuss anticipated challenges to implementing work requirements by the end of 2026, including related system changes and data matching.
The ACA Marketplace Open Enrollment season begins November 1, and with it comes looming changes to the enhanced premium tax credits, increases in out-of-pocket premium payments, new Marketplace eligibility rules, and more. Read our analysis of what these and other changes could mean for new and returning enrollees.
The White House announcement focused on reducing the cost of some IVF drugs and clarifying options for employers to offer standalone fertility benefits for their employees and their dependents. This policy watch examines some key takeaways about the Trump IVF plan.
While more large employers are covering GLP-1 drugs for weight loss, KFF's conversations with employers highlight concerns about the cost of these medications. Many of these employers have considered scaling back coverage of GLP-1 agonists for weight loss, or in some cases, employers are adding or strengthening coverage requirements.
In a commentary on KFF’s 27th employer health benefits survey, President and CEO Dr. Drew Altman discusses the obstacles employers face trying to control their health care costs, and the reasons why they’ve never been meaningful supporters of government cost-containment efforts. He predicts that premium increases expected next year could lead to a new wave of higher deductibles and other forms of cost sharing for the 155 million Americans who rely on employer coverage. Read the column here.
This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, worker contributions, cost-sharing provisions, offer rates, and more. This year's report also looks at how employers are approaching coverage of GLP-1 drugs for weight loss, including their concerns about utilization and cost.
Family premiums for employer-sponsored health insurance reached an average of $26,993 this year, KFF’s annual benchmark health benefits survey of large and smaller employers finds. On average, workers contribute $6,850 annually to the cost of family coverage, with employers paying the rest.
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