Federal Budget

If Congress passes the reconciliation bill with the Finance Committee provision, 22 states might have to reduce their provider taxes on either hospitals or managed care organizations, cutting a key source of state Medicaid funding in those states. This policy watch explains how the Finance Committee provision would reduce states’ Medicaid spending, and the implications for expansion states.

This analysis details the number of people who would become uninsured from policy changes in the ACA Marketplaces and Medicaid. The Congressional Budget Office estimates that, taken together, these changes will result in 16 million more uninsured people in the year 2034 than would otherwise be the case.

In a new column, Dr. Drew Altman, KFF’s President and CEO, discusses the limits of polling on policy, and what we have learned over more than 30 years of polling about how giving people more information and arraying tradeoffs can change opinion, including on the health policy changes and funding cuts in the current reconciliation bill.

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.

KFF is tracking the Affordable Care Act (ACA) provisions in the 2025 federal budget bill, including changes related to enrollment, verifying eligiblity, and filing and reconciliation.

KFF is tracking the Medicare provisions included in the 2025 federal budget reconciliation bill, comparing changes in the House-passed bill, the proposed Senate bill, and current law.

KFF is tracking the Health Savings Accounts provisions included in the 2025 federal budget reconciliation bill. The House-passed bill includes several changes, while the proposed Senate bill does not address HSAs.

This poll finds two-thirds of the public view the “One Big Beautiful Bill” legislation unfavorably, and its favorability erodes further when people hear about its potential health impacts. As Congress debates changes to Medicaid and the ACA as part of the bill, each program’s popularity is at a record high.

Federal spending on the Medicare Advantage quality bonus program has more than quadrupled since 2015, rising to at least $12.7 billion in 2025. Most Medicare Advantage enrollees are in a plan that receives a bonus payment in 2025, with employer- and union-sponsored plans receiving the highest bonus payments and special needs plans receiving the lowest bonus payments, on average.

In his latest column, President and CEO Drew Altman discusses how, with nearly half, or about 10 million MAGA supporters and Republicans receiving coverage through the ACA Marketplaces, the policy changes and cuts being considered by Republicans to the Marketplaces will directly affect their own voters. Altman writes: “Republicans are no longer interested in repealing the ACA but seem comfortable shrinking it significantly if they can, so long as they don’t touch protections for pre-existing conditions, which is now a political third rail.”