Tracking the Affordable Care Act Provisions in the 2025 Reconciliation Bill
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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We’ve Never Seen Health Care Cuts This Big
PerspectiveIn 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, the resulting reductions in Medicaid…
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How Might Changes to the ACA Marketplace Impact Enrollees with Mental Health Conditions?
Issue BriefThis 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.
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Reconciliation Language Could Lead To Cuts in Medicaid State-Directed Payments to Hospitals and Nursing Facilities
Issue BriefThe 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.
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The Implications of Federal SNAP Spending Cuts on Individuals with Medicaid, Medicare and Other Health Coverage
Issue BriefProposed 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.
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Explaining Cost-Sharing Reductions and Silver Loading in ACA Marketplaces
Policy WatchThe 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.
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The Mystery of How Many People Are on Medicaid
From Drew AltmanIn 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.
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CMS Marketplace Rule’s Sunset Provisions Could Help Congress Find Budget Reconciliation Savings
Quick TakeA CMS rule, once finalized, is generally intended to exist permanently or until it is repealed.... This temporary implementation may preserve the potential for the reconciliation bill to generate official savings through changes to ACA marketplaces in later years (2027–2034) if enacted.
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Senate Finance Language Would Further Cut Federal Spending for Medicaid Expansion States
Policy WatchPrior KFF analysis allocated CBO’s federal Medicaid spending reductions and enrollment losses across the states, and this policy watch builds on that analysis to examine the potential impacts in expansion states compared with non-expansion states.
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Which States Might have to Reduce Provider Taxes Under the Senate Reconciliation Bill?
Policy WatchIf 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.