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On July 4, President Trump signed into law a budget reconciliation package once called the “One Big, Beautiful Bill” that includes significant changes to the Medicaid program. This issue brief provides an overview of the Medicaid work requirement provisions.
Under the reconciliation package, federal Medicaid spending in rural areas is estimated to decline by $137 billion, more than the $50 billion appropriated for the rural health fund.
The House Committee on Appropriations approved the FY 2026 National Security, Department of State, and Related Programs (NSRP) appropriations bill and accompanying report on July 23, 2025.
KFF's Health Tracking Poll looks at awareness and perceived impact of the tax and budget law signed by Trump in July 2025. Nearly half of the public says that they expect the new law to generally hurt them and their families, about twice the share who say it will generally help. The law itself remains largely unpopular, with many more people holding unfavorable views than favorable ones.
Nearly half (46%) of the public says that they expect the new tax and budget law signed by President Trump earlier this month to generally hurt them and their families, nearly twice the share (26%) who say it will generally help, a new KFF Health Tracking Poll finds.
This analysis allocates the CBO’s estimated reduction in federal spending in the enacted reconciliation package 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 his latest Beyond the Data column, KFF President and CEO Dr. Drew Altman examines the controversial rural hospital grant program, noting “Will the new $50 billion rural hospital grant program in the big Republican tax and spending law just amount to a bunch of ribbon cutting and big check ceremonies, or will it help rural hospitals offset coming Medicaid cuts, help them in general, or all of the above?”
In his latest Beyond the Data column, President and CEO Dr. Drew Altman discusses whether Democrats can make the Medicaid and ACA cuts a winning political issue before the midterm elections and before most people feel the cuts.
KFF is tracking the Medicaid provisions in the 2025 federal budget bill, including new Medicaid work and verification requirements and a reduction in the expansion match rate for states that use their own funds to cover undocumented immigrants.
Health Provisions in the 2025 Federal Budget Reconciliation Bill Medicaid The Affordable Care Act Medicare Health Savings Accounts Updated: July 8, 2025…
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