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In this brief on Medicaid issues to watch for 2026, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.
This brief describes current state fiscal conditions as states begin fiscal year 2027 budget debates and highlights key areas to watch for Medicaid policy changes as states respond to fiscal challenges and the 2025 reconciliation law.
In a new column, President and CEO Dr. Drew Altman forecasts eight things to look for in health policy in 2026. “First and foremost,” he writes, “is the role health care affordability will play in the midterms.” And, he notes: “The average cost of a family policy for employers could approach $30,000 and cost sharing and deductibles will rise again after plateauing for several years.”
To better understand how states are preparing for Medicaid work requirements, states were asked to discuss anticipated challenges to implementing work requirements by the end of 2026, including related system changes and data matching.
This issue brief describes the hardship exception for individuals living in counties with high unemployment, and using the most recent available county-level unemployment data, estimates the number of counties that could meet the criteria for this exception and the number of expansion enrollees living in those counties who could be exempt from work requirements.
Four experts, including two state Medicaid directors, joined Health Wonk Shop series moderator Larry Levitt in an hour-long discussion of how states will go about implementing the new Medicaid work requirements.
On July 4, President Trump signed into law a budget reconciliation package once called the “One Big, Beautiful Bill” that includes significant changes to the Medicaid program. This issue brief provides an overview of the Medicaid work requirement provisions.
This analysis allocates the CBO’s estimated reduction in federal spending in the enacted reconciliation package 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 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.
To understand the impact of Medicaid work requirements included in the budget reconciliation bill being debated in Congress, KFF has undertaken two different analyses using different data sources. Using 2023 data from the Survey of Income and Program Participation, this analysis looks at the share of adults who work at least 80 hours per month, the reasons some do not, and how consistently individuals meet the requirement over a six-month period.
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