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The 2025 reconciliation law reduced federal Medicaid spending by an estimated $911 billion from 2025 through 2034, some of which stems from new restrictions on Medicaid state directed payments (SDPs) for hospital and other health care services. This issue brief describes SDPs and forthcoming policy changes stemming from the 2025 reconciliation law and the proposed regulation to implement those requirements and make other changes.
Forty states and DC currently receive $93 billion in annual federal Medicaid spending through state directed payments (SDPs) and may be at risk due to forthcoming limits on these payments, according to new KFF estimates. Annual federal spending on SDPs is highest in California (an estimated $10.6 billion)—followed by Texas ($6.3 billion), North Carolina ($5.2 billion), and Illinois ($5.1 billion).
This issue brief analyzes Medicaid spending by state on SDPs that require prior CMS approval to better understand the use of SDPs before new limits in the reconciliation law take effect.
This budget summary provides an analysis of global health funding amounts provided in the FY 2027 House Labor, Health and Human Services, Education, and Related Agencies (Labor HHS) appropriations bill and accompanying report.
This brief describes recent HHS actions (state-specific and nationwide) related to Medicaid program integrity and outlines some open questions about the future of Medicaid program integrity, including which states might become a focus of administration effort.
This brief provides an update on Planned Parenthood closures and participation in the Title X program in the midst of substantial policy changes leading to decreased funding for Planned Parenthood including the One Big Beautiful Bill Act and the withholding of federal Title X funding to Planned Parenthood clinics.
This fact sheet explores the history, funding, and future outlook of the President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. government's major global initiative to combat HIV/AIDS.
This brief explains current Medicaid cost sharing rules and changes made to cost sharing rules by the 2025 reconciliation law, reports on cost sharing amounts states currently impose on ACA expansion adults, and highlights literature on the impact of cost sharing.
This poll finds that less than half of the public now wants the U.S. to play at least a major role in improving the health of people in developing countries. When asked about the administration’s changes to foreign aid and global health, more people perceive a negative impact than a positive one.
This tracker provides regularly updated information on U.S. government funding for global health. It includes historical trends and tracks funding levels for U.S. global health efforts through bilateral and multilateral contributions and by program area and agency.
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