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  • Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies as States Resume Routine Operations

    Report

    A KFF survey of state Medicaid officials examines state Medicaid and CHIP eligibility, enrollment, and renewal policies in place as of January 2025 as states return to routine operations following the unwinding of the continuous enrollment provision. The survey finds that states have broadly adopted policy and system changes to automate and improve the accuracy and efficiency of Medicaid enrollment and renewal processes and provides a baseline of state policies ahead of potential changes to the program.

  • A Medicaid Per Capita Cap: State by State Estimates

    Issue Brief

    This analysis examines the potential impacts on states, Medicaid enrollees, and providers of implementing a per capita cap on federal Medicaid spending, which is one proposal that has been discussed in Congress. Such a plan could decrease federal Medicaid spending by $532 billion to almost $1 trillion over a 10-year period, depending on how states respond. An estimated 15 million people could lose Medicaid coverage by 2034.

  • Medicaid Expansion is a Red and Blue State Issue

    Issue Brief

    With President-elect Trump returning to the White House and Republicans controlling Congress, significant changes to the Medicaid expansion are expected. This data note provides key facts on the Medicaid expansion, highlighting the financial and coverage impacts of any changes across states that voted for President-elect Trump and those that voted for Vice President Harris.

  • Allocating CBO’s Estimates of Federal Medicaid Spending Reductions and Enrollment Loss Across the States: House Reconciliation Bill

    Issue Brief

    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.

  • About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed

    Issue Brief

    This analysis estimates that 48% of adults under age 65 with individual market coverage are either employed by a small business with fewer than 25 workers, self-employed entrepreneurs, or small business owners. Because the vast majority of this coverage is purchased through the Affordable Care Act (ACA) Marketplaces, changes to the ACA, including the expiration of the enhanced premium tax credits at the end of this year, would have significant implications for what small business owners and workers spend on their health care.

  • State-Based Efforts Will Provide Limited Relief from Enhanced Tax Credit Expiration

    Policy Watch

    After failed Senate votes late last year and no subsequent bipartisan agreement, the enhanced premium tax credits expired as of January 1. Some states, particularly those operating State-Based Marketplaces (SBMs), have been preparing for this possibility for months and are moving to blunt the impact on consumers by implementing their own state-funded subsidies and implementing other programs aimed at stabilizing the cost of unsubsidized premiums.