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The 2025 budget reconciliation created the Rural Health Transformation Program, which will award $50 billion in state grants over a five-year period. This brief provides an overview of the program, describing its structure, how funds can be used, how funding compares to Medicaid spending reductions in the reconciliation law, and how the funds are being distributed across and within states.
This brief describes current fiscal conditions using the latest state revenue and spending data from the National Association of State Budget Officers (NASBO) and analyzes how these conditions may impact states’ Medicaid budget decisions going forward.
This issue brief uses data from KFF’s 2025-2026 survey of Medicaid directors and from a proposed rule on provider taxes to describe states’ current provider taxes, explore how rules governing provider taxes are changing because of the 2025 reconciliation law and the regulations implementing that law, and summarizes which changes may affect each state.
An estimated $60 billion in federal Medicaid spending in 37 states (including the District of Columbia) would likely exceed new federal limits on state directed payments for hospital services once fully implemented, a new KFF analysis finds. States with the biggest potential reductions in Medicaid payments to hospitals include California, Illinois, Kentucky, Texas, North Carolina, Louisiana, Arizona and Michigan.
This analysis estimates the number of states impacted by and the amount of current federal spending on Medicaid state directed payments for hospital services that exceeds the new limits established by the 2025 reconciliation law when fully implemented.
The Medicare program will spend at least $13 billion on the Medicare Advantage quality bonus program in 2026, as 68% of Medicare Advantage enrollees are in a plan that qualifies for higher payments under the program.
As the 2026 midterms approach, health care costs remain voters' top health priority, but fraud in government health programs, including Medicaid and Medicare, is resonating with Republican voters, 55% of whom say it's extremely important for candidates to address. Most voters say there is at least “some” fraud in government health programs, but larger shares say there is fraud in the tax system, defense, and foreign aid, while the smallest share sees fraud in the…
Health care costs top the list of voters’ health care priorities for the midterm elections, though more than half of Republican voters say it is extremely important for candidates to discuss the issue of fraud in government health programs, according to a new KFF Health Tracking Poll. Most voters say there is at least “some” fraud in government health programs, but larger shares of voters see fraud in the tax system, defense, and foreign aid…
CBO’s latest projections of Medicaid spending and enrollment from February 2026 show how enrollment and spending are expected to change over the next decade, accounting for the historic policy changes and their expected reductions in future federal Medicaid spending, as well as other economic and technical changes. This policy watch compares CBO’s February 2026 projections of Medicaid spending and enrollment to earlier CBO projections.
Federal payments to Medicare Advantage plans, and adjustments for health status, have come under increased scrutiny. This brief answers key questions about coding intensity, recent steps taken by CMS, the effects on beneficiaries, and other proposals to improve payment accuracy.
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