Federal Budget

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.

In this July 1 column for The New York Times Opinion section, KFF Executive Vice President for Health Policy Larry Levitt explains how the budget reconciliation bill passed by the Senate on July 1 is effectively a partial repeal of the Affordable Care Act (ACA) and, if signed into law,…

This analysis estimates that the House-passed reconciliation bill could lead Medicaid spending in rural areas to decrease by $119 billion and a 1.5 million drop in enrollment over 10 years.

This brief estimates the number of current Marketplace enrollees with a mental health diagnosis to understand what changes in enrollment may mean for access to services. Among the 24.3 million Marketplace enrollees in 2025, over 4.4 million individuals are estimated to have at least one mental health diagnosis on a health care claim.

The Senate Finance Committee’s reconciliation language would reduce existing state-directed payments to hospitals and nursing facilities over time until they are at or slightly above Medicare rates.  This analysis identifies states that might have to reduce payment rates for hospitals or nursing facilities if the language is passed into law.

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.

The House of Representatives recently passed a budget reconciliation bill that would appropriate funding for cost-sharing reductions that insurers are required to provide to low-income enrollees in the Affordable Care Act marketplace. This policy watch explains what these cost-sharing reductions are, how they relate to federal spending, and what effect appropriating funding might have on premiums and the uninsured rate.

In a new column, Dr. Drew Altman, KFF’s President and CEO, examines the different counts of the number of people on Medicaid that are currently in use, which range from 69 to 83 million, and why it might matter. He also discusses other ways to assess the reach of the program: “possibly it’s useful to explain why there are different numbers out there about what seemingly is an all-time simple question: how many people are on Medicaid,” Altman says.

Prior KFF analysis allocated CBO’s federal Medicaid spending reductions and enrollment losses across the states, and this policy watch builds on that analysis to examine the potential impacts in expansion states compared with non-expansion states.

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.