Federal Budget

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.

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.